| gm. Policzna, Precinct no. 4 |
| Vote on 21-11-2010 | |
| Office | Wójt Gminy Policzna |
| Precinct | Precinct no. 4 |
| Electoral Commission Regional Headquarters | Świetlica Wiejska w Chechłach |
| Number of electors | 523 |
| Number of dispensed ballot cards | 251 |
| Number of valid ballot cards | 251 |
| Number of votes valid | 244 |
| Number of votes invalid | 7 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 21-11-2010 23:14 |
| No. | Family name and given names | Age | Education | Address, party membership and endorsements | Number of votes | Votes % | |
| 1 | Łukaszuk Waldemar Wiesław | 55 | średnie | Policzna, submitted by KOMITET WYBORCZY PRAWO I SPRAWIEDLIWOŚĆ, not a member of any political party | 56 | 22,95% | |
| 2 | Pająk Stanisław | 64 | wyższe | Policzna, submitted by KOMITET WYBORCZY WYBORCÓW RAZEM BUDUJEMY, not a member of any political party | 188 | 77,05% | |