| m. Człuchów, Precinct no. 6, Constituency no. 4 | |
| Constituency | Constituency no. 4 |
| Precinct | Precinct no. 6 |
| Electoral Commission Regional Headquarters | Miejski Dom Kultury, ul. Traugutta 2, 77-300 Człuchów |
| Number of electors | 2 018 |
| Number of dispensed ballot cards | 252 |
| Number of valid ballot cards | 252 |
| Number of votes valid | 251 |
| Number of votes invalid | 1 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 01-04-2012 22:49 |
| List no. 1 - KOMITET WYBORCZY CZŁUCHOWSKIE FORUM SAMORZĄDOWE | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Ziemba-Lacroix Małgorzata Beata | 49 | 19,52% | |
| List no. 2 - KOMITET WYBORCZY WYBORCÓW Wojciecha Mroziewicza | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Mroziewicz Wojciech Józef | 31 | 12,35% | |
| List no. 3 - KOMITET WYBORCZY WYBORCÓW ZGODA BUDUJE CZŁUCHÓW | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Meller Marcin | 8 | 3,19% | |
| List no. 4 - KOMITET WYBORCZY WYBORCÓW Mirosława Szałaty | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Szałata Mirosław Waldemar | 40 | 15,94% | |
| List no. 5 - KOMITET WYBORCZY WYBORCÓW CZŁUCHÓW SILNY GOSPODARCZO | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Neckar Irena | 39 | 15,54% | |
| List no. 6 - KOMITET WYBORCZY WYBORCÓW - Bogusławy Konczanin | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Konczanin Bogusława | 16 | 6,37% | |
| List no. 7 - KOMITET WYBORCZY WYBORCÓW Wojciecha Podgórskiego | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Podgórski Wojciech | 49 | 19,52% | |
| List no. 8 - KOMITET WYBORCZY WYBORCÓW CZŁUCHOWSKA INICJATYWA OBYWATELSKA | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Kopczyński Adam Jerzy | 19 | 7,57% | |