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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
032025001260975-3
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
Anticipada
33 . Cod.
3
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
99900
42 . Manifiesto de carga
No. 116575015807341
43 . Año – Mes – Día
2025 – 07 – 15
44 . Documento de transporte
No. SHAN0404983
45 . Año – Mes – Día
2025 – 07 – 05
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
9103606428
52 . Año – Mes – Día
2025 – 07 – 05
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.
3.974.37
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
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.
129.50
72 . Peso neto kgs. dcms.
108.40
73 . Código
embalaje
YY
74 . No. bultos
2
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
400.00
78 .Valor FOB
USD
58.563.27
79 . Valor fletes USD
1.030.82 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
236.856.793
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
236.856.793
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
1.97
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.032.79
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
59.596.06
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: 564611-DECL: 1932412-DO: 893116811251- 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
RESOLUCIÓN 5050 DEL 10 DE NOVIEMBRE DE 2016. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOM
OLOGACIÓN) // NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION.SAMSUNG ELECTRONICS COLOMB
IA S.A. OEA COD. OE0001. . PEDIDOS: 3093045076. ID DELIVERY: 6083031683. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A266MLGHLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A26 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE (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
032025001260975
133. Feha: 202507 08
134 . Levante No. 032025001071873 135 . Fecha
2025 – 07 – 16
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 92032505206248
Fecha presentación 2025-07-08 18:39:10
Valor pagado $0.00
Fecha de Impresión: 2025-07-16 14:42:55
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001260975-3
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
CLARO, MODELO: SM-A266M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A266M/DS,LIGHT GREEN,LTC( QTY. 400,00 u
)(400,00 PCE); IMEIS: 351813978280809/352975138280802. 351813978280817/352975138280810. 351813978280825/352975138280828. 3518139
78280833/352975138280836. 351813978280841/352975138280844. 351813978280858/352975138280851. 351813978280866/352975138280869. 3518
13978280874/352975138280877. 351813978280882/352975138280885. 351813978280908/352975138280901. 351813978280916/352975138280919. 3
51813978280924/352975138280927. 351813978280940/352975138280943. 351813978280957/352975138280950. 351813978280965/352975138280968
.351813978280973/352975138280976. 351813978280999/352975138280992. 351813978281005/352975138281008. 351813978281013/3529751382810
16. 351813978281021/352975138281024. 351813978281039/352975138281032. 351813978281054/352975138281057. 351813978281062/3529751382
81065. 351813978281096/352975138281099. 351813978281104/352975138281107. 351813978281112/352 975138281115. 351813978281120/352975
138281123. 351813978281138/352975138281131. 351813978281146/352975138281149. 351813978281179/352975138281172. 351813978281187/352
975138281180. 351813978281195/352975138281198. 351813978281203/352975138281206. 351813978281211/352975138281214. 351813978281229/
352975138281222. 351813978281237/352975138281230. 351813978281245/352975138281248. 351813978281252/352975138281255. 3518139782812
60/352975138281263. 351813978281278/352975138281271. 351813978281286/352975138281289. 351813978281294/352975138281297. 3518139782
81302/352975138281305. 351813978281310/352975138281313. 351813978281328/352975138281321. 351813978281336/352975138281339. 3518139
78281344/352975138281347. 351813978281351/352975138281354. 351813978281369/352975138281362. 351813978281377/352975138281370. 3518
13978281385/352975138281388. 351813978281393/352975138281396. 351813978281401/352975138281404. 351813978281419/352975138281412. 3
51813978281435/352975138281438. 351813978281450/352975138281453. 351813978281468/352975138281461. 351813978281476/352975138281479
. 351813978281484/352975138281487. 351813978281492/352975138281495. 351813978281500/352975138281503. 351813978281518/352975138281
511. 351813978281526/352975138281529. 351813978281534/352975138281537. 351813978290097/352975138290090. 351813978292184/352975138
292187. 351813978292283/352975138292286. 351813978292358/352975138292351.351813978296680/352975138296683. 351813978300136/3529751
38300139. 351813978304914/352975138304917. 351813978304930/352975138304933. 351813978304963/352975138304966. 351813978304997/3529
75138304990. 351813978305051/352975138305054. 351813978307941/352975138307944. 351813978308238/352975138308231. 351813978308287/3
52975138308280. 351813978308501/352975138308504. 351813978308683/352975138308686. 351813978308949/352975138308942. 35181397831090
3/352975138310906. 351813978312057/352975138312050. 351813978312065/352975138312068. 351813978312073/352975138312076.351813978312
123/352975138312126. 351813978312131/352975138312134. 351813978312149/352975138312142. 351813978312156/352975138312159. 351813978
312198/352975138312191. 351813978312248/352975138312241. 351813978312321/352975138312324. 351813978312347/352975138312340. 351813
978312370/352975138312373. 351813978312412/352975138312415. 351813978312511/352975138312514. 351813978312529/352975138312522. 351
813978312537/352975138312530. 351813978312552/352975138312555. 351813978312578/352975138312571. 351813978312594/352975138312597.
351813978312602/352975138312605. 351813978312628/352975138312621. 351813978312685/352975138312688. 351813978312693/35297513831269
6. 351813978312743/352975138312746. 351813978312750/352975138312753. 351813978312768/352975138312761. 351813978312776/35297513831
2779. 351813978312784/352975138312787. 351813978312818/352975138312811. 351813978312826/352975138312829. 351813978312842/35297513
8312845. 351813978312859/352975138312852. 351813978312883/352975138312886. 351813978312933/352975138312936. 351813978312974/35297
5138312977. 351813978312982/352975138312985. 351813978313014/352975138313017. 351813978313022/352975138313025. 351813978313030/35
2975138313033. 351813978313105/352975138313108. 351813978313147/352975138313140. 351813978313170/352975138313173. 351813978313188
/352975138313181. 351813978313204/352975138313207. 351813978313253/352975138313256. 351813978313261/352975138313264. 351813978313
287/352975138313280. 351813978313303/352975138313306. 351813978313352/352975138313355. 351813978313394/352975138313397. 351813978
313428/352975138313421. 351813978313436/352975138313439. 351813978313485/352975138313488. 351813978313493/352975138313496. 351813
978313519/352975138313512. 351813978313527/352975138313520.351813978313535/352975138313538. 351813978313576/352975138313579. 3518
13978313584/352975138313587. 351813978313600/352975138313603. 351813978313626/352975138313629. 351813978313683/352975138313686. 3
51813978313717/352975138313710. 351813978313733/352975138313736. 351813978313758/352975138313751. 351813978313774/352975138313777
. 351813978313782/352975138313785. 351813978313790/352975138313793. 351813978313808/352975138313801. 351813978313816/352975138313
819. 351813978313824/352975138313827. 351813978313840/352975138313843. 351813978313865/352975138313868.351813978313881/3529751383
13884. 351813978313907/352975138313900. 351813978313915/352975138313918. 351813978313931/352975138313934. 351813978313956/3529751
38313959. 351813978313964/352975138313967. 351813978314004/352975138314007. 351813978314046/352975138314049. 351813978314129/3529
75138314122. 351813978314178/352975138314171. 351813978314186/352975138314189. 351813978314202/352975138314205. 351813978314228/3
52975138314221. 351813978314236/352975138314239. 351813978314269/352975138314262. 351813978314319/352975138314312. 35181397831433
5/352975138314338. 351813978314350/352975138314353. 351813978314376/352975138314379. 351813978314392/352975138314395. 35181397831
4426/352975138314429. 351813978314434/352975138314437. 351813978314467/352975138314460. 351813978314525/352975138314528. 35181397
8314558/352975138314551. 351813978314574/352975138314577. 351813978314582/352975138314585. 351813978314590/352975138314593. 35181
3978314681/352975138314684. 351813978314699/352975138314692. 351813978314723/352975138314726. 351813978314731/352975138314734. 35
1813978314764/352975138314767. 351813978314772/352975138314775. 351813978314798/352975138314791. 351813978314814/352975138314817.
351813978314855/352975138314858. 351813978314871/352975138314874. 351813978314897/352975138314890. 351813978314913/3529751383149
16. 351813978314988/352975138314981. 351813978314996/352975138314999. 351813978315019/352975138315012. 351813978315043/3529751383
15046. 351813978315092/352975138315095. 351813978315142/352975138315145. 351813978315209/352975138315202. 351813978315217/3529751
38315210. 351813978315233/352975138315236. 351813978315258/352975138315251. 351813978315266/352975138315269. 351813978315290/3529
75138315293. 351813978315308/352975138315301.351813978315340/352975138315343. 351813978315357/352975138315350. 351813978315365/35
2975138315368. 351813978315381/352975138315384. 351813978315407/352975138315400. 351813978315415/352975138315418. 351813978315423
/352975138315426. 351813978315431/352975138315434. 351813978315449/352975138315442. 351813978315456/352975138315459. 351813978315
472/352975138315475. 351813978315548/352975138315541. 351813978315555/352975138315558. 351813978315613/352975138315616. 351813978
315621/352975138315624. 351813978315639/352975138315632. 351813978315662/352975138315665.351813978315712/352975138315715. 3518139
78315738/352975138315731. 351813978315746/352975138315749. 351813978315779/352975138315772. 351813978315787/352975138315780. 3518
13978315795/352975138315798. 351813978315811/352975138315814. 351813978315829/352975138315822. 351813978315845/352975138315848. 3
51813978315860/352975138315863. 351813978315878/352975138315871. 351813978315886/352975138315889. 351813978315894/352975138315897
. 351813978315910/352975138315913. 351813978315944/352975138315947. 351813978315969/352975138315962. 351813978315993/352975138315
996. 351813978316009/352975138316002. 351813978316041/352975138316044. 351813978316058/352975138316051. 351813978316108/352975138
316101. 351813978316132/352975138316135. 351813978316140/352975138316143. 351813978316207/352975138316200. 351813978316256/352975
138316259. 351813978316272/352975138316275. 351813978316280/352975138316283. 351813978316298/352975138316291. 351813978316306/352
975138316309. 351813978316389/352975138316382. 351813978316447/352975138316440. 351813978316462/352975138316465. 351813978316504/
352975138316507. 351813978316520/352975138316523. 351813978316538/352975138316531. 351813978316546/352975138316549. 3518139783165
53/352975138316556. 351813978316561/352975138316564. 351813978316603/352975138316606. 351813978316637/352975138316630. 3518139783
16660/352975138316663. 351813978316702/352975138316705. 351813978316728/352975138316721. 351813978316751/352975138316754. 3518139
78316785/352975138316788. 351813978316793/352975138316796. 351813978316801/352975138316804. 351813978316827/352975138316820. 3518
13978316876/352975138316879. 351813978316884/352975138316887. 351813978316892/352975138316895. 351813978316918/352975138316911. 3
51813978316959/352975138316952.351813978316967/352975138316960. 351813978316983/352975138316986. 351813978317056/352975138317059.
351813978317064/352975138317067. 351813978317122/352975138317125. 351813978317148/352975138317141. 351813978317189/3529751383171
82. 351813978317205/352975138317208. 351813978317213/352975138317216. 351813978317262/352975138317265. 351813978317288/3529751383
032025001260975-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001260975-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
17281. 351813978317304/352975138317307. 351813978317320/352975138317323. 351813978317346/352975138317349. 351813978317395/3529751
38317398. 351813978317403/352975138317406. 351813978317429/352975138317422.351813978317460/352975138317463. 351813978317478/35297
5138317471. 351813978317502/352975138317505. 351813978317528/352975138317521. 351813978317536/352975138317539. 351813978317585/35
2975138317588. 351813978317601/352975138317604. 351813978317619/352975138317612. 351813978317650/352975138317653. 351813978317684
/352975138317687. 351813978317726/352975138317729. 351813978317734/352975138317737. 351813978317767/352975138317760. 351813978317
775/352975138317778. 351813978317825/352975138317828. 351813978317858/352975138317851. 351813978317866/352975138317869. 351813978
317882/352975138317885. 351813978317965/352975138317968. 351813978317973/352975138317976. 351813978317981/352975138317984. 351813
978317999/352975138317992. 351813978318005/352975138318008. 351813978318021/352975138318024. 351813978318039/352975138318032. 351
813978318047/352975138318040. 351813978318054/352975138318057. 351813978318062/352975138318065. 351813978318088/352975138318081.
351813978318096/352975138318099. 351813978318146/352975138318149. 351813978318153/352975138318156. 351813978318187/35297513831818
0. 351813978318195/352975138318198. 351813978318211/352975138318214. 351813978318252/352975138318255. 351813978318336/35297513831
8339. 351813978318351/352975138318354. 351813978318641/352975138318644. 351813978318708/352975138318701. 351813978318757/35297513
8318750. 351813978318765/352975138318768. 351813978318773/352975138318776. 351813978318799/352975138318792. 351813978318849/35297
5138318842. 351813978318880/352975138318883. 351813978318971/352975138318974. 351813978319060/352975138319063. 351813978319193/35
2975138319196. 351813978319243/352975138319246. 351813978319276/352975138319279. 351813978319342/352975138319345. 351813978319383
/352975138319386.351813978319433/352975138319436. 351813978319441/352975138319444. 351813978319458/352975138319451. 3518139783194
90/352975138319493. 351813978319532/352975138319535. 351813978319557/352975138319550. 351813978319581/352975138319584. 3518139783
19896/352975138319899. 351813978319904/352975138319907. 351813978319912/352975138319915. 351813978319920/352975138319923. 3518139
78319961/352975138319964. 351813978320043/352975138320046. 351813978320092/352975138320095. 351813978320126/352975138320129. 3518
13978320159/352975138320152. 351813978320175/352975138320178.351813978320217/352975138320210. 351813978320274/352975138320277. 35
1813978320290/352975138320293. 351813978320308/352975138320301. 351813978320324/352975138320327. 351813978320332/352975138320335.
351813978320365/352975138320368. 351813978320373/352975138320376. 351813978320381/352975138320384. 351813978320399/3529751383203
92. 351813978320407/352975138320400. 351813978320415/352975138320418. 351813978320423/352975138320426. 351813978320456/3529751383
20459. 351813978320464/352975138320467. 351813978320472/352975138320475. 351813978320480/352975138320483. 351813978320555/3529751
38320558. 351813978320589/352975138320582. 351813978320647/352975138320640. 351813978320662/352975138320665. 351813978320670/3529
75138320673. 351813978320712/352975138320715. 351813978320720/352975138320723. 351813978320928/352975138320921. 351813978320969/3
52975138320962. 351813978320977/352975138320970. 351813978321066/352975138321069. 351813978321108/352975138321101. 35181397832112
4/352975138321127. 351813978321132/352975138321135. 351813978321140/352975138321143. 351813978321215/352975138321218. 35181397832
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032025001260975-3
Espacio para uso exclusivo de la Entidad Recaudadora
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