PFAS Statement Letter Template: How to Answer a Customer's PFAS Request

A PFAS statement is a signed letter from a supplier telling a customer, part by part, whether PFAS is intentionally added. Customers ask for it because they have to report PFAS in their own products, for example to Minnesota. A letter that answers by part number gives them what they need. A letter that names no parts usually comes back with more questions.

Download the PFAS statement letter template (Word). Put it on your letterhead, list the customer’s part numbers, and sign it.

What should a PFAS statement include?

Section	What to write
Parts covered	The customer’s part number and your part number for every part they asked about
Answer per part	Intentionally added PFAS: Yes, No, or Unknown
For each Yes	The component or material, the PFAS chemical name, the CAS number, the concentration range, and what the PFAS does
Definition used	Minnesota counts any fluorinated organic chemical with at least one fully fluorinated carbon atom. That includes fluoropolymers such as PTFE
Basis	Whether the answer comes from your own data, your suppliers’ declarations, or testing
Signer	Name, title, company email, and date

Use Minnesota’s concentration ranges, so your customer can copy the answer straight into its report: practical detection limit to less than 100 ppm, 100 to less than 1,000 ppm, 1,000 to less than 10,000 ppm, 1% to less than 15%, 15% to less than 30%, 30% to less than 60%, 60% to less than 90%, or 90% to 100%.

Why do customers send back a “PFAS free” letter?

Minnesota reports are filed by product and by component. A letter that says “our products comply with all PFAS regulations” or “we do not use PFAS” names no parts, so your customer cannot tie it to anything it reports. It also leaves out fluoropolymers. PTFE in a seal or a wire jacket is PFAS under Minnesota’s definition, so a “PFAS free” letter written to a narrower definition can be wrong for your customer’s report.

If none of the parts contain PFAS, the letter can be short: list the part numbers and answer No for each.

What if you don’t know yet?

Answer Unknown for those parts, and say that you have asked your own suppliers. Your customer can report a part as containing PFAS with the amount or chemical unknown, but it has to keep asking until the data is known. An honest Unknown with a date for the follow-up is more useful to them than a guess.

Send an updated statement when your suppliers answer. Minnesota report updates are due each February 1.

Do you have to report too?

Possibly. Minnesota’s rule applies to manufacturers of products sold in the state, and a component maker can be one. Manufacturers in the same supply chain can agree on who reports. See Amara’s Law: what Minnesota’s PFAS law requires, or look up whether your company has a published report in PRISM.

TL;DR

Is there an official PFAS statement form?

No. Any signed letter or sheet works if it answers by part number with the PFAS name, CAS number, concentration range, and function for each part that contains PFAS.

Does PTFE count as PFAS?

Yes, under Minnesota’s definition. 88% of the first companies with published Minnesota reports named a fluoropolymer such as PTFE. See what the first reports show.

Can I send one letter for all my parts?

Yes, if the letter lists every part number it covers. A letter that names no parts does not support your customer’s report.

Related PFAS guides

• PFAS supplier declaration template (CSV)
• PFAS supplier request emails
• Minnesota PFAS report lookup
• Minnesota PFAS reporting: how to get the data from your suppliers
• What Minnesota’s first PFAS reports show (PRISM data)

Sources

1. Minn. Stat. 116.943. Definition of PFAS.
2. Minn. Rules 7026.0030. Report contents and concentration ranges.
3. Minn. Rules 7026.0080. Supply chain requests and records.
4. Minn. Rules 7026.0020. Who reports within a supply chain.
5. MPCA supplemental PRISM guide, March 2026. Component level reporting and unknowns.