| gm. Jarocin, Precinct no. 21 |
| Vote on 05-12-2010 | |
| Office | Burmistrz Jarocina |
| Precinct | Precinct no. 21 |
| Electoral Commission Regional Headquarters | Szpital Powiatowy Sp. z o.o., Jarocin, ul. Szpitalna 1 |
| Number of electors | 68 |
| Number of dispensed ballot cards | 7 |
| Number of valid ballot cards | 7 |
| Number of votes valid | 6 |
| Number of votes invalid | 1 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 05-12-2010 22:04 |
| No. | Family name and given names | Age | Education | Address, party membership and endorsements | Number of votes | Votes % | |
| 3 | Kostka Mikołaj | 29 | wyższe | Jarocin, submitted by KOMITET WYBORCZY SOJUSZ LEWICY DEMOKRATYCZNEJ, member of Sojuszu Lewicy Demokratycznej | 3 | 50,00% | |
| 5 | Pawlicki Adam Michał | 45 | średnie | Kadziak, submitted by KOMITET WYBORCZY WYBORCÓW ADAMA PAWLICKIEGO-ZIEMIA JAROCIŃSKA, not a member of any political party | 3 | 50,00% | |
| Vote on 21-11-2010 | |
| Office | Burmistrz Jarocina |
| Precinct | Precinct no. 21 |
| Electoral Commission Regional Headquarters | Szpital Powiatowy Sp. z o.o., Jarocin, ul. Szpitalna 1 |
| Number of electors | 40 |
| Number of dispensed ballot cards | 11 |
| Number of valid ballot cards | 10 |
| Number of votes valid | 10 |
| Number of votes invalid | 0 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 21-11-2010 22:43 |
| No. | Family name and given names | Age | Education | Address, party membership and endorsements | Number of votes | Votes % | |
| 1 | Czechak Lidia | 34 | wyższe | Jarocin, submitted by KOMITET WYBORCZY WYBORCÓW LIDII CZECHAK, member of Prawa i Sprawiedliwości | 2 | 20,00% | |
| 2 | Dworzyński Andrzej Jacek | 47 | wyższe | Radlin, submitted by KOMITET WYBORCZY WYBORCÓW POROZUMIENIE OBYWATELSKIE Z J, member of Platformy Obywatelskiej Rzeczypospolitej Polskiej | 1 | 10,00% | |
| 3 | Kostka Mikołaj | 29 | wyższe | Jarocin, submitted by KOMITET WYBORCZY SOJUSZ LEWICY DEMOKRATYCZNEJ, member of Sojuszu Lewicy Demokratycznej | 0 | 0,00% | |
| 4 | Kycia Dariusz Stanisław | 45 | średnie | Jarocin, submitted by KOMITET WYBORCZY WYBORCÓW GŁOS MIESZKAŃCÓW, not a member of any political party | 0 | 0,00% | |
| 5 | Pawlicki Adam Michał | 45 | średnie | Kadziak, submitted by KOMITET WYBORCZY WYBORCÓW ADAMA PAWLICKIEGO-ZIEMIA JAROCIŃSKA, not a member of any political party | 7 | 70,00% | |
| 6 | Półrolniczak Marcin | 28 | wyższe | Golina, submitted by KOMITET WYBORCZY POLSKIE STRONNICTWO LUDOWE, member of Polskiego Stronnictwa Ludowego | 0 | 0,00% | |
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