Ballot results for the candidate by precinct
| Candidate | Fornal Jacek |
| Age | 39 |
| Address and endorsements | Strzegom |
| Constituency no. | 1 |
| Number of votes for the candidate | 66 |
| % of valid votes for the candidate | 1.71% |
| Number of votes for the list | 894 |
| % of votes for the candidate relating to votes for the list | 7.38% |
| Mandate | No |
gm. Strzegom
| 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 * |
|---|---|---|---|---|---|
| 1 | Publiczna Szkoła Podstawowa Nr 2, 58-150 Strzegom ul. Adama Mickiewicza 1 | 17 |
1.72% 
|
258 |
6.59%
|
| 2 | Publiczna Szkoła Podstawowa Nr 2, 58-150 Strzegom ul. Adama Mickiewicza 1 | 9 |
1.00%
|
154 |
5.84%
|
| 3 | Strzegomskie Centrum Kultury, 58-150 Strzegom ul. I.J. Paderewskiego 36 | 6 |
0.97%
|
138 |
4.35%
|
| 4 | Publiczna Szkoła Podstawowa Nr 4, 58-150 Strzegom Aleja Wojska Polskiego 3-5 | 13 |
3.29%
|
88 |
14.77%
|
| 5 | Publiczna Szkoła Podstawowa Nr 4, 58-150 Strzegom Aleja Wojska Polskiego 3-5 | 21 |
2.20%
|
256 |
8.20%
|