| gm. Chodzież, Precinct no. 3, Constituency no. 3 | |
| Constituency | Constituency no. 3 |
| Precinct | Precinct no. 3 |
| Electoral Commission Regional Headquarters | Świetlica Wiejska, Osiedle Wichrowe Wzgórze 1, Rataje, 64-800 Chodzież |
| Number of electors | 917 |
| Number of dispensed ballot cards | 281 |
| Number of valid ballot cards | 281 |
| Number of votes valid | 278 |
| Number of votes invalid | 3 |
| Number of dispensed ballot cards for plenipotentiaries | 3 |
| Protocol date | 15-07-2012 22:41 |
| List no. 1 - KOMITET WYBORCZY WYBORCÓW FORUM SAMORZĄDOWO-LUDOWE | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Dziamska Hanna Maria | 112 | 40,29% | |
| List no. 2 - KOMITET WYBORCZY WYBORCÓW TERESY SOCH | ||||
| No. | Family name and given names | Number of votes | % of valid votes | |
| 1 | Soch Teresa Elżbieta | 166 | 59,71% | |