Ballot results for the candidate by precinct
| Candidate | Forysiak Agnieszka |
| Age | 33 |
| Address and endorsements | Ozorków |
| Constituency no. | 1 |
| Number of votes for the candidate | 29 |
| % of valid votes for the candidate | 1.27% |
| Number of votes for the list | 289 |
| % of votes for the candidate relating to votes for the list | 10.03% |
| Mandate | No |
m. Ozorków
| 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 Nr 4 ul. Średnia 30 | 3 |
0.34% 
|
64 |
4.69%
|
| 2 | Miejski Ośrodek Kultury ul. Wyszyńskiego 43 | 13 |
1.84%
|
86 |
15.12%
|
| 3 | Młodzieżowy Dom Kultury ul. Listopadowa 6 | 13 |
1.98%
|
136 |
9.56%
|
| 11 | Dom Pomocy Społecznej ul. Mickiewicza 1 | 0 | — | 3 |
0.00%
|