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REPÚBLICA DE COLOMBIA
Declaración de Importación Privada 500
1. Año 2025
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032025001569840-6
5 . Número de Identificación Tributaria (NIT)
830028931
6 . DV.
5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
13 . Dirección
CR 7 113 43 OF 607
15 . Teléfono
4870707
12 . Cód. Admón.
03
16 . Cód. Dpto
11
17 . Cód. Ciudad Municipio
001
24 . Número de Identificación Tributaria (NIT)
860536003
25 . DV.
3
26 . Razón social del declarante autorizado
AGENCIA DE ADUANAS ABC REPECEV S.A.S. NIVEL 1
27 . Tipo usuario
26
28 . Cód. usuario
99
29 . Número documento de identificación
1022943854
30 . Apellidos y nombres
CARLOS ANDRES ROJAS MATAJUDIOS
31 . Clase
Importador
02
32 . Tipo declaración
Inicial
33 . Cod.
1
34 .No.Formulario Anterior
XXXXXXXXXXXXXX
35 . Año – Mes – Día
XXXX – XX – XX
36 . Cod. Admón.
XX
37 . Declaración de Exportación
No. XXXXXXXXXXXXXXX
38 . Año – Mes – Día
XXXX – XX – XX
39 . Cod. Admón.
XX
40 . Cod. lugar ingreso
de las mercancías
BOG
41 . Cod. Depósito
13907
42 . Manifiesto de carga
No. 9194595217
43 . Año – Mes – Día
2025 – 08 – 28
44 . Documento de transporte
No. SHAN0414338
45 . Año – Mes – Día
2025 – 08 – 19
46 . Nombre exportador o proveedor en el exterior
SAMSUNG ELECTRONICS CO., LTD
47 . Ciudad
GYEONGGI-DO
48 . Cod.País Exportador
190
49 . Dirección exportador o proveedor en el exterior
129, SAMSUNG-RO, YEONGTONG-GU SUWON 16677
50 . E-mail
010-8705-6749
51 . No. de factura
9103716500
52 . Año – Mes – Día
2025 – 08 – 19
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
169
56 . Cod. Depto
destino
0
57 . Empresa transportadora
TAMPA CARGO S.A.S.
58 . Tasa de cambio $ cvs.
4.034.18
S 59 . Subpartida arancelaria
8517130000
60 . Cod.
Complementario
XX
61 . Cod.
Suplementario
XX
62 . Cod. Modalidad
C234
63 . No. cuotas
o meses
XX
64 . Valor cuota USD
XXXX
65 . Periodicidad del
pago de la cuota
XX
66 . Cod. país
de origen
855
67 . Cod. Acuerdo
XXX
68 . Forma de pago
de la importación
01
69 . Tipo de
importación
01
70 . Cod. país
compra
190
71 . Peso bruto kgs. dcms.
122.00
72 . Peso neto kgs. dcms.
108.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
400.00
78 .Valor FOB
USD
28.992.30
79 . Valor fletes USD
979.29 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
120.914.783
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
120.914.783
99
0
100
0
101
0.00
Salvaguardia
102
0.00
103
0
104
0
105
0
106
0.00
Derechos
Compensatorios
107
0.00
108
0
109
0
110
0
111
0.00
Derechos
Antidumping
112
0.00
113
0
114
0
115
0
116
0.00
Sancion
117
0
118
0
119
0
120
0
Rescate
121
0
122
0
123
0
124
0
Total 125
0
126
0.00
80 . Valor Seguros
USD
0.99
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
980.28
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
29.972.58
85 . Código registro
o licencia
X
86 . Número
XXXXXXXXXX
87 .
Cod.
oficina
99
88 . Año
XXXX
89 . Programa No
XXXXXXXXXX
90 . Cód Interno del
Producto
0
91 . Descripción de las mercancías(No inicie la descripción de las mercancías a importar con lo señalado en el arancel de aduanas en la subpartida arancelaria – Incluya marcas, seriales y otros) (Si el campo es insuficiente, continúe al respaldo de este formulario)
NAC: 569872-DECL: 1946379-DO: 893120698251- DECL 1 DE 1.- //NOS ACOGEMOS AL ARTICULO 424 DEL ESTATUTO TRIBUTARIO MODIFICADO POR L
A LEY 1819DEL 29/12/2016 ARTÍCULO 175 NUMERAL 6 (EXCLUSIÓN DEL IVA). //NOS ACOGEMOS AL ARTÍCULO 2.8.3.1 ORDINAL 2.8.3.1.4 DE LA R
ESOLUCIÓN 5050 DEL 10DE NOVIEMBRE DE 2016. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN)/ NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANC
IA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3097287358. ID DELIVERY:
6083998107. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A165MLGDLTC, PRODUCTO: TELEFONO CELULAR GALAXY Z Flip7 5GDuos (CON ACCESORIO
S PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE CLARO, MODELO: SM-A165M/DS, USO O DESTINO: PARA LA VENTA (continúa al respaldo)
127 . Valor pagos anteriores: 0 128 . Recibo oficial de pago anterior No.: XXXXXXXXXXXXXXX 129. Fecha: XXXX XX XX
130 . Espacio reservado DIAN – Actuación aduanera
Estado de levante: Levante automático
No hay declaración posterior
131 . Espacio reservado uso exclusivo Ministerio de Relaciones Exteriores 132 . No. Aceptación declaración
032025001569840
133. Feha: 202508 28
134 . Levante No. 032025001314385 135 . Fecha
2025 – 08 – 28
Firma funcionario responsable 136 . Nombre
137 . C.C. No.
Firma declarante 997 . Espacio exclusivo para el sello
de la entidad recaudadora
(Fecha efectiva de la transacción)
Coloque el timbre de la máquina
registradora al dorso de este formulario
980 . Pago Total $
0
996 . Espacio para autoadhesivo de la entidad recaudadora
(Número del adhesivo)
SYGA
Autoadhesivo 92032506702040
Fecha presentación 2025-08-28 22:53:49
Valor pagado $0.00
Fecha de Impresión: 2025-08-28 22:53:54
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001569840-6
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
AL MAYOR Y ALDETAL./ /MOBILE,SM-A165M/DS,LIGHT GREEN,LTC( QTY. 400,00 u )(400,00 PCE); MERCANCIA UBICADA EN: ABC STORAGE S.A.S –
ZFB – Cra. 106 No. 15 A25 Manzana 23 Bodega 135H / IMEIS: 350455584148391/354598224148390. 350455584152278/354598224152277. 35045
5584154829/354598224154828. 350455584174793/354598224174792. 350455584204608/354598224204607. 350455584204848/354598224204847. 35
0455584204863/354598224204862. 350455584204889/354598224204888. 350455584204897/354598224204896. 350455584204905/354598224204904.
350455584204954/354598224204953. 350455584205142/354598224205141. 350455584205274/354598224205273. 350455584205282/3545982242052
81. 350455584205431/354598224205430. 350455584205480/354598224205489. 350455584205530/354598224205539. 350455584205555/3545982242
05554. 350455584205563/354598224205562. 350455584205738/354598224205737. 350455584205969/354598224205968. 350455584205993/3545982
24205992. 350455584206009/354598224206008. 350455584206041/354598224206040. 3504555842062 80/354598224206289. 350455584206348/354
598224206347. 350455584206363/354598224206362. 350455584206413/354598224206412. 350455584206462/354598224206461. 350455584206884/
354598224206883. 350455584207064/354598224207063. 350455584207098/354598224207097. 350455584207122/354598224207121. 3504555842072
39/354598224207238. 350455584207304/354598224207303.350455584207353/354598224207352. 350455584208195/354598224208194. 35045558420
8211/354598224208210. 350455584208252/354598224208251. 350455584208260/354598224208269. 350455584208278/354598224208277. 35045558
4208534/354598224208533. 350455584208542/354598224208541. 350455584208575/354598224208574. 350455584208658/354598224208657. 35045
5584208674/354598224208673. 350455584208682/354598224208681. 350455584208765/354598224208764. 350455584208807/354598224208806. 35
0455584208864/354598224208863. 350455584208872/354598224208871. 350455584208930/354598224208939.350455584208955/354598224208954.
350455584208971/354598224208970. 350455584208989/354598224208988. 350455584208997/354598224208996. 350455584209045/35459822420904
4. 350455584209144/354598224209143. 350455584209219/354598224209218. 350455584209375/354598224209374. 350455584209391/35459822420
9390. 350455584209409/354598224209408. 350455584209433/354598224209432. 350455584209474/354598224209473. 350455584209508/35459822
4209507. 350455584209573/354598224209572. 350455584210126/354598224210125. 350455584210142/354598224210141. 350455584210332/35459
8224210331. 350455584210605/354598224210604. 350455584210621/354598224210620. 350455584211819/354598224211818. 350455584211835/35
4598224211834. 350455584211918/354598224211917. 350455584212437/354598224212436. 350455584212544/354598224212543. 350455584212569
/354598224212568. 350455584212635/354598224212634. 350455584218608/354598224218607. 350455584219036/354598224219035. 350455584220
588/354598224220587. 350455584220620/354598224220629. 350455584220703/354598224220702. 350455584220828/354598224220827. 350455584
220893/354598224220892. 350455584221685/354598224221684. 350455584221776/354598224221775. 350455584222428/354598224222427. 350455
584222519/354598224222518. 350455584222535/354598224222534. 350455584222543/354598224222542. 350455584222600/354598224222609. 350
455584222618/354598224222617. 350455584222683/354598224222682. 350455584222808/354598224222807. 350455584222840/354598224222849.
350455584223202/354598224223201. 350455584223210/354598224223219. 350455584223244/354598224223243. 350455584223251/35459822422325
0. 350455584223269/354598224223268. 350455584223277/354598224223276. 350455584223293/354598224223292. 350455584223327/35459822422
3326. 350455584223335/354598224223334.350455584223343/354598224223342. 350455584223368/354598224223367. 350455584223384/354598224
223383. 350455584223400/354598224223409. 350455584223525/354598224223524. 350455584223657/354598224223656. 350455584223715/354598
224223714. 350455584223749/354598224223748. 350455584223764/354598224223763. 350455584223863/354598224223862. 350455584223889/354
598224223888. 350455584223897/354598224223896. 350455584223939/354598224223938. 350455584223988/354598224223987. 350455584224028/
354598224224027. 350455584225686/354598224225685. 350455584225850/354598224225859.350455584225876/354598224225875. 35045558422642
9/354598224226428. 350455584226452/354598224226451. 350455584226478/354598224226477. 350455584226486/354598224226485. 35045558422
6494/354598224226493. 350455584226510/354598224226519. 350455584226528/354598224226527. 350455584226536/354598224226535. 35045558
4226544/354598224226543. 350455584226551/354598224226550. 350455584228441/354598224228440. 350455584228508/354598224228507. 35045
5584228615/354598224228614. 350455584228821/354598224228820. 350455584228847/354598224228846. 350455584229498/354598224229497. 35
0455584229514/354598224229513. 350455584233029/354598224233028. 350455584233086/354598224233085. 350455584233094/354598224233093.
350455584233151/354598224233150. 350455584233169/354598224233168. 350455584233193/354598224233192. 350455584233326/3545982242333
25. 350455584233417/354598224233416. 350455584233433/354598224233432. 350455584235602/354598224235601. 350455584235644/3545982242
35643. 350455584235784/354598224235783. 350455584235792/354598224235791. 350455584235867/354598224235866. 350455584236121/3545982
24236120. 350455584236212/354598224236211. 350455584236279/354598224236278. 350455584236386/354598224236385. 350455584236436/3545
98224236435. 350455584236451/354598224236450. 350455584236469/354598224236468. 350455584236477/354598224236476. 350455584236600/3
54598224236609. 350455584236626/354598224236625. 350455584236816/354598224236815. 350455584236824/354598224236823. 35045558423687
3/354598224236872. 350455584236881/354598224236880. 350455584236899/354598224236898. 350455584236907/354598224236906. 35045558423
6949/354598224236948. 350455584236956/354598224236955. 350455584236964/354598224236963. 350455584236972/354598224236971. 35045558
4236980/354598224236989.350455584236998/354598224236997. 350455584237020/354598224237029. 350455584237038/354598224237037. 350455
584237046/354598224237045. 350455584237137/354598224237136. 350455584237160/354598224237169. 350455584237277/354598224237276. 350
455584237913/354598224237912. 350455584237921/354598224237920. 350455584237970/354598224237979. 350455584237988/354598224237987.
350455584238325/354598224238324. 350455584238424/354598224238423. 350455584238473/354598224238472. 350455584239034/35459822423903
3. 350455584239778/354598224239777. 350455584239802/354598224239801.350455584239844/354598224239843. 350455584239950/354598224239
959. 350455584239968/354598224239967. 350455584239984/354598224239983. 350455584240016/354598224240015. 350455584240065/354598224
240064. 350455584240818/354598224240817. 350455584240859/354598224240858. 350455584241618/354598224241617. 350455584243481/354598
224243480. 350455584243507/354598224243506. 350455584243564/354598224243563. 350455584244109/354598224244108. 350455584246534/354
598224246533. 350455584246799/354598224246798. 350455584246807/354598224246806. 350455584246872/354598224246871. 350455584249330/
354598224249339. 350455584249546/354598224249545. 350455584249561/354598224249560. 350455584249785/354598224249784. 3504555842498
01/354598224249800. 350455584249827/354598224249826. 350455584249959/354598224249958. 350455584249975/354598224249974. 3504555842
49991/354598224249990. 350455584250114/354598224250113. 350455584250262/354598224250261. 350455584250536/354598224250535. 3504555
84250692/354598224250691. 350455584250809/354598224250808. 350455584250866/354598224250865. 350455584250965/354598224250964. 3504
55584251021/354598224251020. 350455584251187/354598224251186. 350455584251328/354598224251327. 350455584252037/354598224252036. 3
50455584252078/354598224252077. 350455584252110/354598224252119. 350455584252540/354598224252549. 350455584253480/354598224253489
. 350455584253811/354598224253810. 350455584253985/354598224253984. 350455584254256/354598224254255. 350455584254421/354598224254
420. 350455584254660/354598224254669. 350455584254868/354598224254867. 350455584254876/354598224254875. 350455584255030/354598224
255039. 350455584255071/354598224255070. 350455584255212/354598224255211. 350455584255329/354598224255328. 350455584255451/354598
224255450.350455584255469/354598224255468. 350455584255477/354598224255476. 350455584255527/354598224255526. 350455584255634/3545
98224255633. 350455584255865/354598224255864. 350455584255881/354598224255880. 350455584255899/354598224255898. 350455584255972/3
54598224255971. 350455584255998/354598224255997. 350455584256095/354598224256094. 350455584256293/354598224256292. 35045558425671
5/354598224256714. 350455584256764/354598224256763. 350455584258349/354598224258348. 350455584258661/354598224258660. 35045558425
8679/354598224258678. 350455584259545/354598224259544.350455584259560/354598224259569. 350455584259701/354598224259700. 350455584
259735/354598224259734. 350455584259800/354598224259809. 350455584259958/354598224259957. 350455584260006/354598224260005. 350455
584261525/354598224261524. 350455584261632/354598224261631. 350455584261707/354598224261706. 350455584261715/354598224261714. 350
455584261913/354598224261912. 350455584262309/354598224262308. 350455584262317/354598224262316. 350455584262358/354598224262357.
350455584262382/354598224262381. 350455584262614/354598224262613. 350455584262655/354598224262654. 350455584262788/35459822426278
7. 350455584262820/354598224262829. 350455584262846/354598224262845. 350455584262861/354598224262860. 350455584263075/35459822426
3074. 350455584263208/354598224263207. 350455584264222/354598224264221. 350455584264271/354598224264270. 350455584264354/35459822
032025001569840-6
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001569840-6
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
4264353. 350455584264461/354598224264460. 350455584264495/354598224264494. 350455584264537/354598224264536. 350455584264552/35459
8224264551. 350455584264586/354598224264585. 350455584264594/354598224264593. 350455584264602/354598224264601. 350455584264628/35
4598224264627. 350455584264677/354598224264676. 350455584264693/354598224264692. 350455584264701/354598224264700. 350455584265765
/354598224265764. 350455584267084/354598224267083. 350455584267092/354598224267091. 350455584267100/354598224267109. 350455584267
118/354598224267117. 350455584267142/354598224267141. 350455584267167/354598224267166. 350455584267175/354598224267174. 350455584
267209/354598224267208. 350455584267241/354598224267240. 350455584267266/354598224267265. 350455584267308/354598224267307. 350455
584268405/354598224268404. 350455584269536/354598224269535. 350455584269619/354598224269618. 350455584269668/354598224269667.3504
55584269684/354598224269683. 350455584269718/354598224269717. 350455584270328/354598224270327. 350455584270450/354598224270459. 3
50455584270476/354598224270475. 350455584270625/354598224270624. 350455584270633/354598224270632. 350455584270641/354598224270640
. 350455584270674/354598224270673. 350455584270690/354598224270699. 350455584270708/354598224270707. 350455584270740/354598224270
749. 350455584270773/354598224270772. 350455584270799/354598224270798. 350455584270807/354598224270806. 350455584271151/354598224
271150. 350455584271201/354598224271200.350455584271227/354598224271226. 350455584271334/354598224271333. 350455584271383/3545982
24271382. 350455584271425/354598224271424. 350455584271474/354598224271473. 350455584271524/354598224271523. 350455584271623/3545
98224271622. 350455584271664/354598224271663. 350455584271722/354598224271721. 350455584272613/354598224272612. 350455584272621/3
54598224272620. 350455584272688/354598224272687. 350455584272696/354598224272695. 350455584272969/354598224272968. 35045558427300
9/354598224273008. 350455584273033/354598224273032. 350455584273058/354598224273057. 350455584273066/354598224273065. 35045558427
3074/354598224273073. 350455584273082/354598224273081. 350455584273132/354598224273131. 350455584273140/354598224273149. 35045558
4273157/354598224273156. 350455584273165/354598224273164. 350455584273439/354598224273438. 350455584273470/354598224273479. 35045
5584273488/354598224273487. 350455584273587/354598224273586. 350455584273637/354598224273636. 350455584273728/354598224273727. 35
0455584273777/354598224273776. 350455584273785/354598224273784. 350455584273793/354598224273792. 350455584277307/354598224277306.
350455584277331/354598224277330. 350455584277398/354598224277397. 350455584277414/354598224277413. 350455584278289/3545982242782
88. 350455584278362/354598224278361. 350455584278388/354598224278387. 350455584278404/354598224278403. 350455584278479/3545982242
78478. 350455584278487/354598224278486. 350455584278503/354598224278502. 350455584278511/354598224278510. 350455584278537/3545982
24278536. 350455584278545/354598224278544. 350455584278552/354598224278551. 350455584282919/354598224282918. 350455584284816/3545
98224284815. 350455584285102/354598224285101. 350455584285326/354598224285325. 350455584285383/354598224285382.350455584285433/35
4598224285432. 350455584285466/354598224285465. 350455584285540/354598224285549. 350455584286316/354598224286315. 350455584286324
/354598224286323. 350455584286340/354598224286349. 350455584286373/354598224286372. 350455584286381/354598224286380. 350455584286
456/354598224286455. 350455584286662/354598224286661. 350455584286670/354598224286679. 350455584286696/354598224286695. 350455584
286829/354598224286828. 350455584287041/354598224287040. 350455584293304/354598224293303XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025001569840-6
Espacio para uso exclusivo de la Entidad Recaudadora
