Ballot results for the candidate by precinct
| Candidate | Herman Teresa Maria |
| Age | 51 |
| Address and endorsements | Kamienna Góra |
| Constituency no. | 4 |
| Number of votes for the candidate | 23 |
| % of valid votes for the candidate | 1.14% |
| Number of votes for the list | 448 |
| % of votes for the candidate relating to votes for the list | 5.13% |
| Mandate | No |
m. Kamienna Góra
| 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 * |
|---|---|---|---|---|---|
| 10 | Osiedle Krzeszowskie, ulica Wałbrzyska 26, Kamienna Góra | 22 |
2.02% 
|
272 |
8.09%
|
| 11 | Centrum Kultury ul.Kościuszki 4, Kamiena Góra | 1 |
0.11%
|
162 |
0.62%
|
| 12 | Dolnośląskie Centrum Rehabilitacji ul.Korczaka 1, Kamienna Góra | 0 | — | 14 |
0.00%
|