Ballot results for the candidate by precinct
| Candidate | Kłos Henryk |
| Age | 65 |
| Address and endorsements | Rogóźno |
| Constituency no. | 11 |
| Number of votes for the candidate | 69 |
| % of valid votes for the candidate | 11.00% |
| Number of votes for the list | 0 |
| % of votes for the candidate relating to votes for the list | — |
| Mandate | No |
gm. Tomaszów Lubelski
| 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 | Urząd Gminy, 22-600 Tomaszów Lubelski | 63 |
18.42% 
|
128 |
49.22%
|
| 12 | Świetlica Wiejska w Rogóźnie | 6 |
2.11%
|
13 |
46.15%
|