| gm. Ustrzyki Dolne, Precinct no. 12 |
| Vote on 21-11-2010 | |
| Office | Burmistrz Ustrzyk Dolnych |
| Precinct | Precinct no. 12 |
| Electoral Commission Regional Headquarters | Dom Pomocy Społecznej, Moczary, Moczary |
| Number of electors | 231 |
| Number of dispensed ballot cards | 90 |
| Number of valid ballot cards | 90 |
| Number of votes valid | 80 |
| Number of votes invalid | 10 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 21-11-2010 22:14 |
| No. | Family name and given names | Age | Education | Address, party membership and endorsements | Votes for | Votes against | Votes % | |
| 1 | Sułuja Henryk Ignacy | 50 | wyższe | Ustrzyki Dolne, submitted by KOMITET WYBORCZY BIESZCZADZKIEGO STOWARZYSZENIA SAMORZĄDOWEGO W USTRZYKACH DOLNYCH, not a member of any political party | 74 | 6 | 92,50% | |