Ballot results for the candidate by precinct
| Candidate | Kozłowska Dorota Agata |
| Age | 37 |
| Address and endorsements | Polkowice |
| Constituency no. | 4 |
| Number of votes for the candidate | 3 |
| % of valid votes for the candidate | 0.10% |
| Number of votes for the list | 36 |
| % of votes for the candidate relating to votes for the list | 8.33% |
| Mandate | No |
gm. Polkowice
| 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 | Gimnazjum Nr 2, ul. Hubala 3 | 1 |
0.15% 
|
10 |
10.00%
|
| 2 | Szkoła Podstawowa Nr 2 (sala gminastyczna), Polkowice ul. Dąbrowskiego 1A | 0 | — | 5 |
0.00%
|
| 12 | Szkoła Podstawowa Integracyjna w Jędrzychowie | 1 |
0.17%
|
11 |
9.09%
|
| 13 | Sala Gimnastyczna w Suchej Górnej | 0 | — | 6 |
0.00%
|
| 14 | Oddział Przedszkola Miejskiego w Tarnówku | 1 |
0.21%
|
4 |
25.00%
|