Ballot results for the candidate by precinct
| Candidate | Domański Tadeusz Adam |
| Age | 48 |
| Address and endorsements | Chocianów |
| Constituency no. | 3 |
| Number of votes for the candidate | 106 |
| % of valid votes for the candidate | 14.38% |
| Number of votes for the list | 0 |
| % of votes for the candidate relating to votes for the list | — |
| Mandate | No |
gm. Chocianów
| No. | Address | Number of votes | % of valid votes* | Number of votes for the list | % of votes for the candidate relating to votes for the list * |
|---|---|---|---|---|---|
| 3 | Chocianowski Ośrodek Kultury w Chocianowie, ul. Kościuszki 5 | 106 |
14.38% 
|
106 |
100.00%
|