Ballot results for the candidate by precinct
| Candidate | Biernacka Teresa |
| Age | 50 |
| Address and endorsements | Dobrocin , endorsed by Samoobronę Rzeczpospolitej Polskiej |
| Constituency no. | 4 |
| Number of votes for the candidate | 20 |
| % of valid votes for the candidate | 4.39% |
| Number of votes for the list | 0 |
| % of votes for the candidate relating to votes for the list | — |
| Mandate | No |
gm. Dzierżoniów
| 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 * |
|---|---|---|---|---|---|
| 4 | Przedszkole Gminne, Dobrocin ul. Kościuszki 22 | 17 |
6.69% 
|
33 |
51.52%
|
| 10 | Wiejski Ośrodek Kultury, Roztocznik 41a | 3 |
1.49%
|
8 |
37.50%
|