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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
032025001577653-9
5 . Número de Identificación Tributaria (NIT)
800091549
6 . DV.
2
11 . Apellidos y nombres o Razón Social
IMPRESISTEM S A S
13 . Dirección
AUT MEDELLIN CL 80 KM 2
15 . Teléfono
8766500
12 . Cód. Admón.
03
16 . Cód. Dpto
25
17 . Cód. Ciudad Municipio
214
24 . Número de Identificación Tributaria (NIT)
830122083
25 . DV.
6
26 . Razón social del declarante autorizado
AGENCIA DE ADUANAS LATINOAMERICANA DE ADUANAS SAS NIVEL 2
27 . Tipo usuario
26
28 . Cód. usuario
459
29 . Número documento de identificación
1023862658
30 . Apellidos y nombres
GONZALEZ ACERO KELLY JOHANNA
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
26924
42 . Manifiesto de carga
No. 116575015964354
43 . Año – Mes – Día
2025 – 08 – 26
44 . Documento de transporte
No. ECM120063BOG
45 . Año – Mes – Día
2025 – 08 – 15
46 . Nombre exportador o proveedor en el exterior
IMC INTERNATIONAL INC
47 . Ciudad
MIAMI
48 . Cod.País Exportador
249
49 . Dirección exportador o proveedor en el exterior
7707 NW 46 STREET MIAMI, FL 33166
50 . E-mail
3059947965
51 . No. de factura
23608
52 . Año – Mes – Día
2025 – 08 – 12
53 . Cod. país
procedencia
215
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
249
56 . Cod. Depto
destino
0
57 . Empresa transportadora
UNITED AIR LINES INC SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.019.09
S 59 . Subpartida arancelaria
8517130000
60 . Cod.
Complementario
XX
61 . Cod.
Suplementario
XX
62 . Cod. Modalidad
C134
63 . No. cuotas
o meses
XX
64 . Valor cuota USD
XXXX
65 . Periodicidad del
pago de la cuota
XX
66 . Cod. país
de origen
215
67 . Cod. Acuerdo
XXX
68 . Forma de pago
de la importación
03
69 . Tipo de
importación
01
70 . Cod. país
compra
249
71 . Peso bruto kgs. dcms.
702.00
72 . Peso neto kgs. dcms.
631.80
73 . Código
embalaje
PK
74 . No. bultos
4
75 . Subpartidas
1
76 . Cod. unidad
comercialU
77 . Cantidad dcms.
1.250.00
78 .Valor FOB USD 79 . Valor fletes USD
Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($)
Total Liquidado
(USD)
Arancel 92
0.00
93 94
0
95
0
96
0.00
I.V.A. 97
0.00
98 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 81 . Valor Otros Gastos USD
0
82 . Sumatoria de fletes, seguros
y otros gastos USD
83 . Ajuste valor USD
0.00
84 . Valor aduana USD 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)
DO 202534942 CODIGO / RESOLUCION OEA IMPORTADOR: OE0169; DECLARACION(2-2) NOS ACOGEMOS AL ART 424 DEL ESTATUTO TRIBUTARIO MODIFIC
ADO POR LEY 1819 DE 29 DE DICIEMBRE 2016, NUEVA REFORMA TRIBUTARIA, ART 175 PARA COMPUTADORES PORTATILES, DE ESCRITORIO TABLETAS
Y CELULARES. HOMOLOGACIÓN DEL EQUIPO MARCA: REDMI, MODELO: 25078RA3EL, RADICACION: 2025519080, FECHA: 2025-06-20// DOCUMENTO DE V
ERIFICACION DE IMEI: DV-239402 FECHA: 2025-08-20//. FACTURA: 23608 FECHA: 2025-08-12 NOS ACOGEMOS AL DECRETO 1881 DEL 2021, NOS A
COGEMOS AL DECRETO 0925 DE MAYO 9 DEL 2013, MINISTERIO DE COMERCIO EXTERIOR, IMPORTACIÓN EXENTA DE REGISTRO DE IMPORTACIÓN.. CANT
(1250) U TELEFONO CELULAR, 1066854 REDMI 15C MINT GREEN 4GB RAM 128GB ROM // ESPECIFICACIONES: PROCESADOR:(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
032025001577653
133. Feha: 2025 09 01
134 . Levante No. 032025001321369 135 . Fecha
2025 – 09 – 01
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 92032506742214
Fecha presentación 2025-09-01 08:06:37
Valor pagado $0.00
Fecha de Impresión: 2025-09-01 08:10:39
IM
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001577653-9
Subpartida : 8517130000
Página 1 de 7
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
Mediatek Helio G81 Ultra (12 nm), PANTALLA: 6,9 PULGADAS (17.53 CM), SISTEMA OPERATIVO: Android 15, HyperOS 2, CAPACIDAD MEMORIA
: 4GB, CAPACIDAD ALMACENAMIENTO: 128GB // EAN: 6932554455903 // REDMI 15C VERDE MENTA 4GBRAM 128 ROM, ALIMENTACION: 5V=3A/3.6-11V
=3A 33W MAX, 50MP AI DUAL CAMERA SYSTEM, BATERIA DE 6000 WAH(TIP) CARGA RAPIDA DE 33 W, TASA DE ACTUALIZACION 12HZ, CONTIENE: ADA
PTADOR, CABLE USB TIPO-C, LLAVE PARA SIM CARD, CARCASA PROTECTORA, GUIA DE INICIO RAPIDO, TARJETA DE GARANTIA; PRODUCTO: TELEFONO
CELULAR, MARCA: REDMI/MI, MODELO: 25078RA3EL, REFERENCIA: 69183/MZB0LBJUS, USO O DESTINO: COMUNICACIÓN, PARA ALMACENAMIENTO Y PR
OCESAMIENTO DE DATOS, SERIAL//IMEI NO. (CODIGO DE QUINCE -15- DIGITOS): 69183/65V101249//866939082614126//866939082614134, 69183/
65V101250//866939082614142//866939082614159, 69183/65V101251//866939082614167//866939082614175, 69183/65V101252//866939082614183/
/866939082614191, 69183/65V101253//866939082614209//866939082614217, 69183/65V101254//866939082614225//866939082614233, 69183/65V
101255//866939082614241//866939082614258, 69183/65V101256//866939082614266//866939082614274, 69183/65V101257//866939082614282//86
6939082614290, 69183/65V101258//866939082614308//866939082614316, 69183/65V101259//866939082614324//866939082614332, 69183/65V101
260//866939082614340//866939082614357, 69183/65V101261//866939082614365//866939082614373, 69183/65V101262//866939082614381//86693
9082614399, 69183/65V101263//866939082614407//866939082614415, 69183/65V101264//866939082614423//866939082614431, 69183/65V101265
//866939082615727//866939082615735, 69183/65V101266//866939082615743//866939082615750, 69183/65V101267//866939082615768//86693908
2615776, 69183/65V101268//866939082615784//866939082615792, 69183/65V101269//866939082615800//866939082615818, 69183/65V101270//8
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5875, 69183/65V101273//866939082615883//866939082615891, 69183/65V101274//866939082615909//866939082615917, 69183/65V101275//8669
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4, 69183/65V101278//866939082615982//866939082615990, 69183/65V101279//866939082616006//866939082616014, 69183/65V101280//8669390
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69183/65V101283//866939082605041//866939082605058, 69183/65V101284//866939082605066//866939082605074, 69183/65V101285//8669390826
05082//866939082605090, 69183/65V101286//866939082605108//866939082605116, 69183/65V101287//866939082605124//866939082605132, 691
83/65V101288//866939082605140//866939082605157, 69183/65V101289//866939082605165//866939082605173, 69183/65V101290//8669390826051
81//866939082605199, 69183/65V101291//866939082605207//866939082605215, 69183/65V101292//866939082605223//866939082605231, 69183/
65V101293//866939082605249//866939082605256, 69183/65V101294//866939082605264//866939082605272, 69183/65V101295//866939082605280/
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101298//866939082605348//866939082605355, 69183/65V101299//866939082605363//866939082605371, 69183/65V101300//866939082605389//86
6939082605397, 69183/65V101301//866939082605405//866939082605413, 69183/65V101302//866939082605421//866939082605439, 69183/65V101
303//866939082605447//866939082605454, 69183/65V101304//866939082605462//866939082605470, 69183/65V101305//866939082607088//86693
9082607096, 69183/65V101306//866939082607104//866939082607112, 69183/65V101307//866939082607120//866939082607138, 69183/65V101309
//866939082607161//866939082607179, 69183/65V101310//866939082607187//866939082607195, 69183/65V101311//866939082607203//86693908
2607211, 69183/65V101312//866939082607229//866939082607237, 69183/65V101313//866939082607245//866939082607252, 69183/65V101315//8
66939082607286//866939082607294, 69183/65V101316//866939082607302//866939082607310, 69183/65V101317//866939082607328//86693908260
7336, 69183/65V101318//866939082607344//866939082607351, 69183/65V101319//866939082607369//866939082607377, 69183/65V101320//8669
39082607385//866939082607393, 69183/65V101346//866939082672082//866939082672090, 69183/65V101421//866939082673601//86693908267361
9, 69183/65V101454//866939082674286//866939082674294, 69183/65V101458//866939082674369//866939082674377, 69183/65V101464//8669390
82658800//866939082658818, 69183/65V101465//866939082658826//866939082658834, 69183/65V101466//866939082658842//866939082658859,
69183/65V101467//866939082658867//866939082658875, 69183/65V101468//866939082658883//866939082658891, 69183/65V101469//8669390826
58909//866939082658917, 69183/65V101470//866939082658925//866939082658933, 69183/65V101471//866939082658941//866939082658958, 691
83/65V101472//866939082658966//866939082658974, 69183/65V101473//866939082658982//866939082658990, 69183/65V101474//8669390826747
40//866939082674757, 69183/65V101475//866939082674765//866939082674773, 69183/65V101476//866939082674781//866939082674799, 69183/
65V101477//866939082674807//866939082674815, 69183/65V101478//866939082674823//866939082674831, 69183/65V101479//866939082674849/
/866939082674856, 69183/65V101481//866939082674880//866939082674898, 69183/65V101482//866939082674906//866939082674914, 69183/65V
101483//866939082674922//866939082674930, 69183/65V101484//866939082674948//866939082674955, 69183/65V101485//866939082674963//86
6939082674971, 69183/65V101486//866939082674989//866939082674997, 69183/65V101487//866939082675002//866939082675010, 69183/65V101
488//866939082675028//866939082675036, 69183/65V101489//866939082675044//866939082675051, 69183/65V101490//866939082675069//86693
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//866939082675127//866939082675135, 69183/65V101494//866939082675143//866939082675150, 69183/65V101495//866939082675168//86693908
2675176, 69183/65V101496//866939082675184//866939082675192, 69183/65V101497//866939082675200//866939082675218, 69183/65V101498//8
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032025001577653-9
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001577653-9
Subpartida : 8517130000
Página 2 de 7
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
/866939082628316, 69183/65V101573//866939082628324//866939082628332, 69183/65V101574//866939082628340//866939082628357, 69183/65V
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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//866939082679004//866939082679012, 69183/65V310955//866939082679020//866939082679038, 69183/65V310956//866939082679046//86693908
2679053, 69183/65V310957//866939082679061//866939082679079, 69183/65V310958//866939082679087//866939082679095, 69183/65V310959//8
66939082679103//866939082679111, 69183/65V310960//866939082679129//866939082679137, 69183/65V310961//866939082686389//86693908268
6397, 69183/65V310962//866939082686405//866939082686413, 69183/65V310963//866939082686421//866939082686439, 69183/65V310964//8669
39082686447//866939082686454, 69183/65V310965//866939082686462//866939082686470, 69183/65V310966//866939082686488//86693908268649
6, 69183/65V310967//866939082686504//866939082686512, 69183/65V310968//866939082686520//866939082686538, 69183/65V310969//8669390
82686546//866939082686553, 69183/65V310970//866939082686561//866939082686579, 69183/65V310971//866939082686587//866939082686595,
69183/65V310972//866939082686603//866939082686611, 69183/65V310973//866939082686629//866939082686637, 69183/65V310974//8669390826
86645//866939082686652, 69183/65V310975//866939082686660//866939082686678, 69183/65V310976//866939082686686//866939082686694, 691
83/65V310978//866939082686728//866939082686736, 69183/65V310979//866939082686744//866939082686751, 69183/65V310980//8669390826867
69//866939082686777, 69183/65V310981//866939082686785//866939082686793, 69183/65V310983//866939082686827//866939082686835, 69183/
65V310984//866939082686843//866939082686850, 69183/65V310985//866939082686868//866939082686876, 69183/65V310986//866939082686884/
/866939082686892, 69183/65V310987//866939082686900//866939082686918, 69183/65V310988//866939082686926//866939082686934, 69183/65V
310989//866939082686942//866939082686959, 69183/65V310990//866939082686967//866939082686975, 69183/65V310991//866939082701824//86
6939082701832, 69183/65V310993//866939082701865//866939082701873, 69183/65V310995//866939082701907//866939082701915, 69183/65V311
124//866939082689763//866939082689771, 69183/65V311141//866939082690100//866939082690118, 69183/65V311159//866939082690464//86693
9082690472, 69183/65V311164//866939082691363//866939082691371, 69183/65V311166//866939082691405//866939082691413, 69183/65V311167
//866939082691421//866939082691439, 69183/65V311168//866939082691447//866939082691454, 69183/65V311174//866939082697063//86693908
2697071, 69183/65V311179//866939082697162//866939082697170, 69183/65V311180//866939082697188//866939082697196, 69183/65V311183//8
66939082697246//866939082697253, 69183/65V311188//866939082697345//866939082697352, 69183/65V311236//866939082693484//86693908269
3492, 69183/65V311374//866939082695729//866939082695737, 69183/65V311385//866939082695943//866939082695950, 69183/65V311414//8669
39082705429//866939082705437, 69183/65V311423//866939082705601//866939082705619, 69183/65V311424//866939082705627//86693908270563
5, 69183/65V311426//866939082705668//866939082705676, 69183/65V311427//866939082705684//866939082705692, 69183/65V311430//8669390
82707680//866939082707698, 69183/65V311437//866939082707821//866939082707839, 69183/65V311439//866939082707862//866939082707870,
69183/65V311440//866939082707888//866939082707896, 69183/65V311446//866939082709603//866939082709611, 69183/65V311463//8669390826
77545//866939082677552, 69183/65V311464//866939082677560//866939082677578, 69183/65V311493//866939082685548//866939082685555, 691
83/65V311496//866939082685605//866939082685613, 69183/65V311501//866939082685704//866939082685712, 69183/65V311517//8669390826889
06//866939082688914, 69183/65V311518//866939082688922//866939082688930, 69183/65V311519//866939082688948//866939082688955, 69183/
65V311520//866939082688963//866939082688971, 69183/65V311521//866939082696404//866939082696412, 69183/65V311522//866939082696420/
/866939082696438, 69183/65V311523//866939082696446//866939082696453, 69183/65V311525//866939082696487//866939082696495, 69183/65V
311527//866939082696529//866939082696537, 69183/65V311528//866939082696545//866939082696552, 69183/65V311529//866939082696560//86
6939082696578, 69183/65V311530//866939082696586//866939082696594, 69183/65V311531//866939082696602//866939082696610, 69183/65V311
541//866939082696800//866939082696818, 69183/65V311543//866939082696842//866939082696859, 69183/65V311554//866939082700982//86693
9082700990, 69183/65V311555//866939082701006//866939082701014, 69183/65V311556//866939082701022//866939082701030, 69183/65V311557
//866939082701048//866939082701055, 69183/65V311559//866939082701089//866939082701097, 69183/65V311560//866939082701105//86693908
2701113, 69183/65V311563//866939082679186//866939082679194, 69183/65V311565//866939082679228//866939082679236, 69183/65V311566//8
66939082679244//866939082679251, 69183/65V311567//866939082682081//866939082682099, 69183/65V311568//866939082682107//86693908268
2115, 69183/65V311569//866939082682123//866939082682131, 69183/65V311570//866939082682149//866939082682156, 69183/65V311571//8669
39082682164//866939082682172, 69183/65V311572//866939082682180//866939082682198, 69183/65V311575//866939082682248//86693908268225
5, 69183/65V311576//866939082682263//866939082682271, 69183/65V311577//866939082682289//866939082682297, 69183/65V311578//8669390
82682305//866939082682313, 69183/65V311579//866939082682321//866939082682339, 69183/65V311580//866939082682347//866939082682354,
69183/65V311581//866939082682362//866939082682370, 69183/65V311582//866939082682388//866939082682396, 69183/65V311584//8669390826
82420//866939082682438, 69183/65V311585//866939082682446//866939082682453, 69183/65V311587//866939082682487//866939082682495, 691
83/65V311589//866939082682529//866939082682537, 69183/65V311592//866939082682586//866939082682594, 69183/65V311595//8669390826826
44//866939082682651, 69183/65V311597//866939082682685//866939082682693, 69183/65V311598//866939082682701//866939082682719, 69183/
65V311599//866939082682727//866939082682735, 69183/65V311600//866939082682743//866939082682750,, NO 4500030481, PAIS ORIGEN: CHIN
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032025001577653-9
Espacio para uso exclusivo de la Entidad Recaudadora
