| gm. Nowy Żmigród, Precinct no. 3, Constituency no. 3 | |
| Constituency | Constituency no. 3 |
| Precinct | Precinct no. 3 |
| Electoral Commission Regional Headquarters | Dom Ludowy w Tokach, Toki 137, 38-230 Nowy Żmigród |
| Number of electors | 540 |
| Number of dispensed ballot cards | 242 |
| Number of valid ballot cards | 242 |
| Number of votes valid | 237 |
| Number of votes invalid | 5 |
| Number of dispensed ballot cards for plenipotentiaries | 3 |
| Protocol date | 17-06-2012 22:19 |
| List no. 1 - KOMITET WYBORCZY WYBORCÓW "Bierzmy sprawy w swoje ręce" | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Samsel Halina Zdzisława | 160 | 67,51% | |
| List no. 2 - KOMITET WYBORCZY WYBORCÓW Haliny Kmieć | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Kmieć Halina Janina | 77 | 32,49% | |