Ballot results for the candidate by precinct
| Candidate | Dorosz Jan Adam |
| Age | 43 |
| Address and endorsements | Andrzejów |
| Constituency no. | 4 |
| Number of votes for the candidate | 37 |
| % of valid votes for the candidate | 33.33% |
| Number of votes for the list | 0 |
| % of votes for the candidate relating to votes for the list | — |
| Mandate | Yes |
gm. Urszulin
| 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 * |
|---|---|---|---|---|---|
| 2 | Zespół Szkół w Urszulinie, (Gimnazjum) | 37 |
33.33% 
|
37 |
100.00%
|