Ballot results for the candidate by precinct
| Candidate | Ślusarczyk Barbara |
| Age | 27 |
| Address and endorsements | Dolice , endorsed by Samoobronę Rzeczpospolitej Polskiej |
| Constituency no. | 1 |
| Number of votes for the candidate | 29 |
| % of valid votes for the candidate | 3.33% |
| Number of votes for the list | 0 |
| % of votes for the candidate relating to votes for the list | — |
| Mandate | No |
gm. Dolice
| 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 | Szkoła Podstawowa w Dolicach | 27 |
3.22% 
|
27 |
100.00%
|
| 7 | Świetlica Domu Pomocy Społecznej w Dolicach | 2 |
6.06%
|
2 |
100.00%
|