Ballot results for the candidate by precinct
| Candidate | Tomczak Mirosława Grażyna |
| Age | 52 |
| Address and endorsements | Gołuchów , endorsed by Samoobronę Rzeczpospolitej Polskiej |
| Constituency no. | 3 |
| Number of votes for the candidate | 75 |
| % of valid votes for the candidate | 9.55% |
| Number of votes for the list | 0 |
| % of votes for the candidate relating to votes for the list | — |
| Mandate | No |
gm. Gołuchów
| 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 | Urząd Gminy w Gołuchowie ul. Lipowa 1 | 75 |
9.55% 
|
75 |
100.00%
|