| gm. Werbkowice, Precinct no. 5, Constituency no. 5 | |
| Constituency | Constituency no. 5 |
| Precinct | Precinct no. 5 |
| Electoral Commission Regional Headquarters | Szkoła Podstawowa, Malice 37, 22-550 Werbkowice |
| Number of electors | 663 |
| Number of dispensed ballot cards | 224 |
| Number of valid ballot cards | 224 |
| Number of votes valid | 223 |
| Number of votes invalid | 1 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 19-09-2011 09:45 |
| List no. 1 - KOMITET WYBORCZY WYBORCÓW MACIEJA BUCZYŃSKIEGO | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Buczyński Maciej Maurycy | 116 | 52,02% | |
| List no. 2 - KOMITET WYBORCZY WYBORCÓW TADEUSZA RYBCZYŃSKIEGO | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Rybczyński Tadeusz Franciszek | 48 | 21,52% | |
| List no. 3 - KOMITET WYBORCZY WYBORCÓW KRYSTYNY KAPUSTY | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Kapusta Krystyna Maria | 59 | 26,46% | |