| gm. Potęgowo, Precinct no. 5, Constituency no. 3 | |
| Constituency | Constituency no. 3 |
| Precinct | Precinct no. 5 |
| Electoral Commission Regional Headquarters | Świetlica Wiejska, Żochowo, 76-230 Potęgowo |
| Number of electors | 450 |
| Number of dispensed ballot cards | 114 |
| Number of valid ballot cards | 114 |
| Number of votes valid | 93 |
| Number of votes invalid | 21 |
| Number of dispensed ballot cards for plenipotentiaries | 0 |
| Protocol date | 18-12-2011 22:30 |
| List no. 1 - KOMITET WYBORCZY WYBORCÓW WIELISZEWO | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Siemińska Genowefa | 49 | 52,69% | |
| List no. 2 - KOMITET WYBORCZY WYBORCÓW KAZIMIERZA BRONISŁAWA OKRÓJ | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Okrój Kazimierz Bronisław | 44 | 47,31% | |