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Supplier PFAS Declaration Template (Free, Copy-Paste)

A free supplier PFAS declaration template for consumer brands: what to ask, the exact fields to include, how to review answers, and common red flags.

BBugra, Founder of Secuabase· 2026-10-19 · 7 min read

Every PFAS compliance program runs on one document: the supplier PFAS declaration. It's how you learn what's in the materials you buy, and it's the evidence regulators, retailers and lawyers will look at first.

Below is a free template you can copy, plus tips on how to send it and review the answers.

Key takeaways

  • Ask about each material, not about the supplier in general.
  • Ask about intentionally added PFAS and PFAS used in manufacturing.
  • Get chemical names, CAS numbers, function and amount if PFAS is present.
  • Require a date and a named signer. Renew yearly.

The template

Copy this into your own document or form. Fill one declaration per material, or use a table for several materials from the same supplier.


PFAS DECLARATION – SUPPLIER MATERIAL

Section A – Supplier information

  • Supplier legal name:
  • Address:
  • Contact name, title, email:

Section B – Material information

  • Material name / trade name:
  • Supplier item or article number:
  • Customer (brand) item number:
  • Description (e.g., "2.5-layer nylon shell with PU membrane and DWR"):
  • Production site (mill / factory):

Section C – PFAS questions

Definition used: PFAS means any substance containing at least one fully fluorinated carbon atom. This includes fluoropolymers such as PTFE, ePTFE, FEP, PFA and PVDF.

  1. Has any PFAS been intentionally added to this material or any of its components? ☐ Yes ☐ No
  2. Has any PFAS been used in manufacturing this material (e.g., processing aid, mold release, finish), even if it may not remain? ☐ Yes ☐ No ☐ Unknown
  3. Does this material contain any fluoropolymer (e.g., PTFE, ePTFE)? ☐ Yes ☐ No
  4. If yes to 1, 2 or 3, please list for each PFAS:
    • Chemical name:
    • CAS number:
    • Function (e.g., water repellency, stain resistance, nonstick, processing aid):
    • Concentration or range (ppm or %):
  5. Do you have test data for this material? ☐ Yes ☐ No
    • If yes: test type (e.g., total organic fluorine, targeted PFAS), lab, date, result, reporting limit. Please attach the report.
  6. For textiles sold in California: is total organic fluorine below 50 ppm? ☐ Yes ☐ No ☐ Not tested
  7. For EU food-contact packaging: does the material meet PPWR PFAS limits (25 ppb / 250 ppb / 50 ppm)? ☐ Yes ☐ No ☐ N/A

Section D – Commitments

  • The supplier will notify the customer in writing before any change in chemistry, finish, membrane, coating, sub-supplier or production site that could affect PFAS content.
  • The supplier confirms the information above is accurate to the best of its knowledge after reasonable inquiry of its own suppliers.

Section E – Signature

  • Name:
  • Title:
  • Signature:
  • Date:

How to send it

  1. Pre-fill what you know. Supplier name, material names and your item numbers. It saves them time and cuts errors.
  2. List every material you buy from that supplier. One request, many materials.
  3. Explain why. One or two sentences on the laws involved (Minnesota, California, etc.).
  4. Set a date. Ten business days is reasonable.
  5. Follow up on schedule. See getting suppliers to respond.

How to review the answers

Check each declaration against these questions:

Check Why it matters
Does it name the exact material you buy? General company letters don't prove anything about a specific fabric
Is question 2 (manufacturing use) answered? Processing aids can leave residue
Is the fluoropolymer question answered? Many suppliers don't treat PTFE as PFAS
If "yes," are CAS numbers, function and amount given? You need these for Minnesota reporting
Is test data attached and does it match the material? Wrong material or old test = weak evidence
Is it signed and dated by a named person? Unsigned forms are weak evidence

Red flags

  • "We comply with all applicable laws." (Not an answer.)
  • "Our company does not use PFAS." (Not material-specific.)
  • "PFOA-free." (Says nothing about other PFAS.)
  • "C0 DWR" with nothing about membranes or trims.
  • No signature, or signed by "Sales Team."
  • A test report from years ago on a different lot or color.

Example: a good answer vs. a weak answer

Weak answer (zipper supplier):

"We confirm our products comply with REACH and all applicable regulations. We do not use PFOA."

Problems: no material named, no answer to the PFAS question, PFOA is one substance among thousands, no signer.

Good answer (same supplier, after a follow-up):

Material: #5 coil zipper, water-resistant, ref. Z5-WR. Q1: No intentionally added PFAS. Q2: No PFAS used in manufacture. Q3: No fluoropolymers; coating is polyurethane. Test: TOF <10 ppm, accredited lab, report attached, dated last month. Signed: Quality Manager, named, dated.

That's the difference between a document that protects you and one that doesn't.

Tips for multi-material suppliers

Some suppliers sell you dozens of materials. To keep it manageable:

  • Send one spreadsheet version of the form with a row per material.
  • Ask for one signature covering the whole sheet.
  • Attach tests by material reference in the file name.
  • Agree on a yearly date when they refresh the sheet.

Translating the request

Many suppliers are outside the US. A short cover note in the supplier's language and clear, simple English in the form improve response rates. Avoid legal jargon. Define PFAS once, at the top.

Where declarations fit in your file

Declarations sit next to your bill of materials and test reports in a per-product file. See the audit-ready compliance evidence file and certificate of compliance vs. test report.

More questions

"Should we accept supplier-designed forms?" Yes, if they answer every question in yours. Map their fields to your template and ask for anything missing.

"Do we need declarations for packaging too?" Yes, especially for food-contact packaging and for EPR data. One request can cover both.

What to do this week

  1. Copy the template into your own document or form tool.
  2. Pre-fill it for your top five suppliers with their materials and item numbers.

Key terms

  • Declaration: A signed supplier statement about a specific material's PFAS status.
  • Processing aid: A substance used during manufacturing that may leave residue.
  • Fluoropolymer: PTFE, ePTFE, FEP, PFA, PVDF and similar; PFAS under most state laws.
  • Reasonable inquiry: The supplier's effort to check with its own suppliers before signing.

Still have questions?

"Can we use one declaration for all colors of a fabric?" Only if the supplier confirms all colors share the same finish and chemistry. Otherwise, list colors separately.

The bottom line

A good declaration is specific: one material, clear answers, chemical details if PFAS is present, test data where available, and a named signer. Pre-fill it, send it to every supplier, and renew it every year.

How Secuabase helps

We send this request to every supplier, pre-filled, follow up on schedule, read every answer, and flag the red flags above. You get a clean declaration on file for every material, with gaps clearly marked.

For our first partners we run it free on one product line. Book a quick chat.

FAQ

What should a supplier PFAS declaration include?
Supplier and material identity, yes/no on intentionally added PFAS, chemical details if yes, test data, date and a named signer.

Is it legally required?
Usually not a specific form, but regulators expect supply chain information, and declarations are the main evidence.

How often to renew?
Yearly, and on any change.


General information, not legal advice. Adapt the template with counsel for your contracts. Facts checked October 2026.

Sources

Frequently asked questions

What should a supplier PFAS declaration include?

The supplier and material identity, a clear yes/no on intentionally added PFAS, chemical names and CAS numbers if yes, the function and amount, any test data, the date, and a named signer.

Is a supplier PFAS declaration legally required?

Laws don't usually require a specific form, but regulators expect manufacturers to collect supply chain information. Signed declarations are the most common evidence.

How often should I renew PFAS declarations?

At least once a year, and whenever a supplier changes a material, finish, mill or process.

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