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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
032025000866029-9
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. 116575015523626
43 . Año – Mes – Día
2025 – 04 – 30
44 . Documento de transporte
No. HKG0404188
45 . Año – Mes – Día
2025 – 04 – 23
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
6900357743
52 . Año – Mes – Día
2025 – 04 – 15
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
244
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.329.90
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
01
69 . Tipo de
importación
01
70 . Cod. país
compra
190
71 . Peso bruto kgs. dcms.
172.00
72 . Peso neto kgs. dcms.
135.50
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
500.00
78 .Valor FOB
USD
30.826.48
79 . Valor fletes USD
1.204.00 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
138.695.487
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
138.695.487
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
1.55
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.205.55
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
32.032.03
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: 555621-DECL: 1909660-DO: 893110267251- 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: 3087892100. ID DELIVERY: 6081674433. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZSGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, MO(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
032025000866029
133. Feha: 202504 25
134 . Levante No. 032025000709313 135 . Fecha
2025 – 05 – 02
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 92032503231543
Fecha presentación 2025-04-25 21:11:13
Valor pagado $0.00
Fecha de Impresión: 2025-05-02 11:48:47
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000866029-9
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,SILVER,LTC( QTY. 500,00 u )(500,00 PCE);
IMEIS: 351641246339010/351847826339011. 351641246339036/351847826339037. 351641246339051/351847826339052. 351641246339069/351847
826339060. 351641246339093/351847826339094. 351641246311290/351847826311291. 351641246311316/351847826311317. 351641246311324/351
847826311325. 351641246311365/351847826311366. 351641246311431/351847826311432. 351641246311456/351847826311457. 351641246311464/
351847826311465. 351641246311480/351847826311481. 351641246311514/351847826311515. 351641246311530/351847826311531. 3516412463115
48/351847826311549. 351641246311571/351847826311572. 351641246311589/351847826311580. 351641246311605/351847826311606. 3516412463
11613/351847826311614. 351641246311621/351847826311622. 351641246311639/351847826311630. 351641246311647/351847826311648. 3516412
46311654/351847826311655. 351641246311662/351847826311663. 351641246311670/351847826311671. 3 51641246311704/351847826311705. 351
641246311712/351847826311713. 351641246311761/351847826311762. 351641246311779/351847826311770. 351641246311803/351847826311804.
351641246311829/351847826311820. 351641246311845/351847826311846. 351641246311860/351847826311861. 351641246311878/35184782631187
9. 351641246311894/351847826311895. 351641246311910/351847826311911. 351641246311944/351847826311945. 351641246311951/35184782631
1952. 351641246311969/351847826311960. 351641246311977/351847826311978. 351641246311985/351847826311986. 351641246312025/35184782
6312026.351641246312033/351847826312034. 351641246312041/351847826312042. 351641246312249/351847826312240. 351641246312256/351847
826312257. 351641246312272/351847826312273. 351641246312280/351847826312281. 351641246312355/351847826312356. 351641246312371/351
847826312372. 351641246312405/351847826312406. 351641246312439/351847826312430. 351641246312462/351847826312463. 351641246313056/
351847826313057. 351641246313296/351847826313297. 351641246314997/351847826314998. 351641246315184/351847826315185. 3516412463154
16/351847826315417. 351641246315465/351847826315466.351641246315804/351847826315805. 351641246316323/351847826316324. 35164124631
6562/351847826316563. 351641246316745/351847826316746. 351641246317198/351847826317199. 351641246317370/351847826317371. 35164124
6317560/351847826317561. 351641246317586/351847826317587. 351641246318170/351847826318171. 351641246318378/351847826318379. 35164
1246318436/351847826318437. 351641246318469/351847826318460. 351641246318501/351847826318502. 351641246318725/351847826318726. 35
1641246319079/351847826319070. 351641246319590/351847826319591. 351641246320192/351847826320193. 351641246320549/351847826320540.
351641246320671/351847826320672. 351641246320713/351847826320714. 351641246320796/351847826320797. 351641246320838/3518478263208
39. 351641246320887/351847826320888. 351641246320895/351847826320896. 351641246320903/351847826320904. 351641246320911/3518478263
20912. 351641246320945/351847826320946. 351641246320952/351847826320953. 351641246320978/351847826320979. 351641246320994/3518478
26320995. 351641246321000/351847826321001. 351641246321026/351847826321027. 351641246321034/351847826321035. 351641246321042/3518
47826321043. 351641246321067/351847826321068. 351641246325209/351847826325200. 351641246325217/351847826325218. 351641246325266/3
51847826325267. 351641246325274/351847826325275. 351641246325282/351847826325283. 351641246325308/351847826325309. 35164124632531
6/351847826325317. 351641246325324/351847826325325. 351641246325423/351847826325424. 351641246325431/351847826325432. 35164124632
5456/351847826325457. 351641246325464/351847826325465. 351641246325498/351847826325499. 351641246325597/351847826325598. 35164124
6325605/351847826325606. 351641246325621/351847826325622. 351641246325639/351847826325630. 351641246325662/351847826325663.351641
246325696/351847826325697. 351641246325704/351847826325705. 351641246325720/351847826325721. 351641246325738/351847826325739. 351
641246325753/351847826325754. 351641246325761/351847826325762. 351641246325829/351847826325820. 351641246325894/351847826325895.
351641246326009/351847826326000. 351641246326074/351847826326075. 351641246326207/351847826326208. 351641246326249/35184782632624
0. 351641246326280/351847826326281. 351641246326306/351847826326307. 351641246326330/351847826326331. 351641246326348/35184782632
6349. 351641246326355/351847826326356.351641246326363/351847826326364. 351641246326421/351847826326422. 351641246326447/351847826
326448. 351641246326454/351847826326455. 351641246326488/351847826326489. 351641246326496/351847826326497. 351641246326512/351847
826326513. 351641246326538/351847826326539. 351641246326546/351847826326547. 351641246326553/351847826326554. 351641246321117/351
847826321118. 351641246321190/351847826321191. 351641246321240/351847826321241. 351641246321299/351847826321290. 351641246321315/
351847826321316. 351641246321323/351847826321324. 351641246321331/351847826321332. 351641246321349/351847826321340. 3516412463213
56/351847826321357. 351641246321372/351847826321373. 351641246321471/351847826321472. 351641246321489/351847826321480. 3516412463
21539/351847826321530. 351641246321547/351847826321548. 351641246321562/351847826321563. 351641246321570/351847826321571. 3516412
46321596/351847826321597. 351641246321646/351847826321647. 351641246321653/351847826321654. 351641246321661/351847826321662. 3516
41246321711/351847826321712. 351641246321737/351847826321738. 351641246321745/351847826321746. 351641246321794/351847826321795. 3
51641246321802/351847826321803. 351641246321836/351847826321837. 351641246321844/351847826321845. 351641246321851/351847826321852
. 351641246321885/351847826321886. 351641246321893/351847826321894. 351641246321901/351847826321902. 351641246321968/351847826321
969. 351641246321984/351847826321985. 351641246321992/351847826321993. 351641246322008/351847826322009. 351641246322016/351847826
322017. 351641246322024/351847826322025. 351641246322099/351847826322090. 351641246322115/351847826322116. 351641246322214/351847
826322215. 351641246322248/351847826322249. 351641246322271/351847826322272. 351641246322289/351847826322280.351641246322297/3518
47826322298. 351641246322305/351847826322306. 351641246322313/351847826322314. 351641246322354/351847826322355. 351641246322362/3
51847826322363. 351641246322370/351847826322371. 351641246322396/351847826322397. 351641246322404/351847826322405. 35164124632243
8/351847826322439. 351641246322453/351847826322454. 351641246322487/351847826322488. 351641246322552/351847826322553. 35164124632
2560/351847826322561. 351641246322594/351847826322595. 351641246322602/351847826322603. 351641246322669/351847826322660. 35164124
6322701/351847826322702.351641246322743/351847826322744. 351641246322776/351847826322777. 351641246322784/351847826322785. 351641
246322792/351847826322793. 351641246322800/351847826322801. 351641246322818/351847826322819. 351641246322826/351847826322827. 351
641246322834/351847826322835. 351641246322859/351847826322850. 351641246322867/351847826322868. 351641246322875/351847826322876.
351641246322883/351847826322884. 351641246322891/351847826322892. 351641246322941/351847826322942. 351641246322958/35184782632295
9. 351641246322966/351847826322967. 351641246322974/351847826322975. 351641246322982/351847826322983. 351641246322990/35184782632
2991. 351641246323014/351847826323015. 351641246323030/351847826323031. 351641246323048/351847826323049. 351641246323055/35184782
6323056. 351641246323063/351847826323064. 351641246323071/351847826323072. 351641246323089/351847826323080. 351641246323097/35184
7826323098. 351641246323105/351847826323106. 351641246323113/351847826323114. 351641246323121/351847826323122. 351641246323139/35
1847826323130. 351641246323147/351847826323148. 351641246323154/351847826323155. 351641246323162/351847826323163. 351641246323170
/351847826323171. 351641246323196/351847826323197. 351641246323204/351847826323205. 351641246323212/351847826323213. 351641246323
246/351847826323247. 351641246323253/351847826323254. 351641246323287/351847826323288. 351641246323303/351847826323304. 351641246
323329/351847826323320. 351641246323352/351847826323353. 351641246323378/351847826323379. 351641246323444/351847826323445. 351641
246323485/351847826323486. 351641246323493/351847826323494. 351641246323501/351847826323502. 351641246323519/351847826323510. 351
641246323527/351847826323528. 351641246323543/351847826323544. 351641246323592/351847826323593.351641246323600/351847826323601. 3
51641246323618/351847826323619. 351641246323659/351847826323650. 351641246323667/351847826323668. 351641246323683/351847826323684
. 351641246323709/351847826323700. 351641246323717/351847826323718. 351641246323733/351847826323734. 351641246323774/351847826323
775. 351641246323782/351847826323783. 351641246323790/351847826323791. 351641246323808/351847826323809. 351641246323816/351847826
323817. 351641246323824/351847826323825. 351641246323840/351847826323841. 351641246323857/351847826323858. 351641246323873/351847
826323874.351641246323881/351847826323882. 351641246323899/351847826323890. 351641246323907/351847826323908. 351641246323915/3518
47826323916. 351641246323923/351847826323924. 351641246323931/351847826323932. 351641246323949/351847826323940. 351641246323956/3
51847826323957. 351641246323972/351847826323973. 351641246324053/351847826324054. 351641246324061/351847826324062. 35164124632410
3/351847826324104. 351641246324137/351847826324138. 351641246324145/351847826324146. 351641246324251/351847826324252. 35164124632
4277/351847826324278. 351641246324335/351847826324336. 351641246324368/351847826324369. 351641246324376/351847826324377. 35164124
032025000866029-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000866029-9
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
6324418/351847826324419. 351641246324459/351847826324450. 351641246324467/351847826324468. 351641246324491/351847826324492. 35164
1246324517/351847826324518. 351641246324525/351847826324526. 351641246324533/351847826324534. 351641246324624/351847826324625. 35
1641246324673/351847826324674. 351641246324699/351847826324690. 351641246324715/351847826324716. 351641246324723/351847826324724.
351641246324756/351847826324757. 351641246324772/351847826324773. 351641246324780/351847826324781. 351641246324863/3518478263248
64. 351641246324871/351847826324872. 351641246324897/351847826324898. 351641246324913/351847826324914. 351641246324954/3518478263
24955. 351641246324988/351847826324989. 351641246325019/351847826325010. 351641246325027/351847826325028. 351641246325035/3518478
26325036. 351641246325068/351847826325069. 351641246325076/351847826325077. 351641246325084/351847826325085. 351641246325092/3518
47826325093. 351641246325159/351847826325150. 351641246325167/351847826325168. 351641246325191/351847826325192. 351641246326561/3
51847826326562. 351641246326579/351847826326570. 351641246326587/351847826326588.351641246326595/351847826326596. 351641246326603
/351847826326604. 351641246326611/351847826326612. 351641246326629/351847826326620. 351641246326645/351847826326646. 351641246326
678/351847826326679. 351641246326686/351847826326687. 351641246326694/351847826326695. 351641246326710/351847826326711. 351641246
326728/351847826326729. 351641246326736/351847826326737. 351641246326835/351847826326836. 351641246326850/351847826326851. 351641
246326876/351847826326877. 351641246326884/351847826326885. 351641246326892/351847826326893. 351641246326900/351847826326901.3516
41246326918/351847826326919. 351641246326934/351847826326935. 351641246326942/351847826326943. 351641246326959/351847826326950. 3
51641246326967/351847826326968. 351641246326975/351847826326976. 351641246326983/351847826326984. 351641246327007/351847826327008
. 351641246327015/351847826327016. 351641246327023/351847826327024. 351641246327031/351847826327032. 351641246327049/351847826327
040. 351641246327056/351847826327057. 351641246327064/351847826327065. 351641246327072/351847826327073. 351641246327080/351847826
327081. 351641246327098/351847826327099. 351641246327106/351847826327107. 351641246327114/351847826327115. 351641246327122/351847
826327123. 351641246327148/351847826327149. 351641246327155/351847826327156. 351641246327171/351847826327172. 351641246327189/351
847826327180. 351641246327197/351847826327198. 351641246327205/351847826327206. 351641246327213/351847826327214. 351641246327239/
351847826327230. 351641246327247/351847826327248. 351641246327254/351847826327255. 351641246327262/351847826327263. 3516412463272
70/351847826327271. 351641246327288/351847826327289. 351641246327296/351847826327297. 351641246327320/351847826327321. 3516412463
27346/351847826327347. 351641246327353/351847826327354. 351641246327361/351847826327362. 351641246327387/351847826327388. 3516412
46327395/351847826327396. 351641246327403/351847826327404. 351641246327411/351847826327412. 351641246327429/351847826327420. 3516
41246328336/351847826328337. 351641246328351/351847826328352. 351641246328716/351847826328717. 351641246329201/351847826329202. 3
51641246329243/351847826329244. 351641246329300/351847826329301. 351641246329532/351847826329533. 351641246331421/351847826331422
. 351641246331462/351847826331463. 351641246331835/351847826331836.351641246332684/351847826332685. 351641246332965/3518478263329
66. 351641246333112/351847826333113. 351641246333195/351847826333196. 351641246333617/351847826333618. 351641246333815/3518478263
33816. 351641246334060/351847826334061. 351641246334243/351847826334244. 351641246334318/351847826334319. 351641246334516/3518478
26334517. 351641246334623/351847826334624. 351641246334771/351847826334772. 351641246335000/351847826335001. 351641246335224/3518
47826335225. 351641246336230/351847826336231. 351641246336396/351847826336397. 351641246336453/351847826336454.351641246336495/35
1847826336496. 351641246336529/351847826336520. 351641246336545/351847826336546. 351641246336552/351847826336553. 351641246336578
/351847826336579. 351641246336602/351847826336603. 351641246336628/351847826336629. 351641246336636/351847826336637. 351641246336
644/351847826336645. 351641246336651/351847826336652. 351641246336669/351847826336660. 351641246336677/351847826336678. 351641246
336685/351847826336686. 351641246336693/351847826336694. 351641246336701/351847826336702. 351641246336719/351847826336710. 351641
246336743/351847826336744. 351641246336750/351847826336751. 351641246336826/351847826336827. 351641246336834/351847826336835. 351
641246336842/351847826336843. 351641246336859/351847826336850. 351641246336867/351847826336868. 351641246336883/351847826336884.
351641246336891/351847826336892. 351641246336909/351847826336900. 351641246336933/351847826336934. 351641246336982/35184782633698
3. 351641246337030/351847826337031. 351641246337055/351847826337056. 351641246337089/351847826337080. 351641246337097/35184782633
7098. 351641246337733/351847826337734. 351641246337766/351847826337767. 351641246337782/351847826337783. 351641246337790/35184782
6337791. 351641246337808/351847826337809. 351641246337816/351847826337817. 351641246337840/351847826337841. 351641246337873/35184
7826337874. 351641246337881/351847826337882. 351641246337899/351847826337890. 351641246337907/351847826337908. 351641246337915/35
1847826337916. 351641246337923/351847826337924. 351641246337931/351847826337932. 351641246337964/351847826337965. 351641246337972
/351847826337973. 351641246337980/351847826337981. 351641246337998/351847826337999. 351641246338004/351847826338005. 351641246338
012/351847826338013. 351641246338020/351847826338021.351641246338038/351847826338039. 351641246338053/351847826338054. 3516412463
38061/351847826338062. 351641246338087/351847826338088. 351641246338111/351847826338112. 351641246338129/351847826338120. 3516412
46338137/351847826338138. 351641246338178/351847826338179. 351641246338186/351847826338187. 351641246338194/351847826338195. 3516
41246338202/351847826338203. 351641246338210/351847826338211. 351641246338228/351847826338229. 351641246338244/351847826338245. 3
51641246338343/351847826338344. 351641246338392/351847826338393. 351641246338400/351847826338401.351641246338442/351847826338443.
351641246338459/351847826338450. 351641246338483/351847826338484. 351641246338491/351847826338492. 351641246338517/3518478263385
18. 351641246338525/351847826338526. 351641246338541/351847826338542. 351641246338558/351847826338559. 351641246338566/3518478263
38567. 351641246338574/351847826338575. 351641246338582/351847826338583. 351641246338608/351847826338609. 351641246338616/3518478
26338617. 351641246338624/351847826338625. 351641246338632/351847826338633. 351641246338640/351847826338641. 351641246338657/3518
47826338658. 351641246338665/351847826338666. 351641246338673/351847826338674. 351641246338681/351847826338682XXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025000866029-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 3
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
032025000867234-7
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. 116575015521368
43 . Año – Mes – Día
2025 – 04 – 30
44 . Documento de transporte
No. HKG0416996
45 . Año – Mes – Día
2025 – 04 – 22
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
6900357483
52 . Año – Mes – Día
2025 – 04 – 15
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
249
56 . Cod. Depto
destino
0
57 . Empresa transportadora
ATLAS AIR INC SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.329.90
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
01
69 . Tipo de
importación
01
70 . Cod. país
compra
190
71 . Peso bruto kgs. dcms.
171.00
72 . Peso neto kgs. dcms.
135.50
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
500.00
78 .Valor FOB
USD
30.833.48
79 . Valor fletes USD
1.197.00 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
138.695.487
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
138.695.487
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
1.55
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.198.55
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
32.032.03
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: 555646-DECL: 1909761-DO: 893110188251- 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. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOMOL
OGACIÓN)// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA
S.A. OEA COD. OE0001. . PEDIDOS: 3087883469. ID DELIVERY: 6081677353. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MLGGLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOSPARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE CLARO,(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
032025000867234
133. Feha: 202504 26
134 . Levante No. 032025000708396 135 . Fecha
2025 – 05 – 02
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 92032503239595
Fecha presentación 2025-04-26 11:44:34
Valor pagado $0.00
Fecha de Impresión: 2025-05-02 09:56:11
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000867234-7
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MODELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,LIGHT GREEN,LTC( QTY. 500,00 u )(500,
00 PCE); IMEIS: 351641246367573/351847826367574. 351641246367599/351847826367590. 351641246367607/351847826367608. 35164124636763
1/351847826367632. 351641246367649/351847826367640. 351641246354829/351847826354820. 351641246354837/351847826354838. 35164124635
4845/351847826354846. 351641246354852/351847826354853. 351641246354860/351847826354861. 351641246354878/351847826354879. 35164124
6354886/351847826354887. 351641246354894/351847826354895. 351641246354936/351847826354937. 351641246354977/351847826354978. 35164
1246354985/351847826354986. 351641246355016/351847826355017. 351641246355024/351847826355025. 351641246355032/351847826355033. 35
1641246355065/351847826355066. 351641246355073/351847826355074. 351641246355081/351847826355082. 351641246355099/351847826355090.
351641246355107/351847826355108. 351641246355123/351847826355124. 351641246355131/351847826 355132. 351641246355149/351847826355
140. 351641246355156/351847826355157. 351641246355172/351847826355173. 351641246355198/351847826355199.351641246355206/3518478263
55207. 351641246355222/351847826355223. 351641246355248/351847826355249. 351641246355255/351847826355256. 351641246355263/3518478
26355264. 351641246355313/351847826355314. 351641246355321/351847826355322. 351641246355388/351847826355389. 351641246355396/3518
47826355397. 351641246355404/351847826355405. 351641246355412/351847826355413. 351641246355420/351847826355421. 351641246355453/3
51847826355454. 351641246355479/351847826355470. 351641246355644/351847826355645. 351641246355669/351847826355660. 35164124635574
3/351847826355744.351641246355768/351847826355769. 351641246355834/351847826355835. 351641246355875/351847826355876. 351641246355
883/351847826355884. 351641246355909/351847826355900. 351641246355933/351847826355934. 351641246355941/351847826355942. 351641246
355966/351847826355967. 351641246355990/351847826355991. 351641246356006/351847826356007. 351641246356014/351847826356015. 351641
246356030/351847826356031. 351641246356105/351847826356106. 351641246356113/351847826356114. 351641246356121/351847826356122. 351
641246356139/351847826356130. 351641246356162/351847826356163. 351641246356204/351847826356205. 351641246356212/351847826356213.
351641246356246/351847826356247. 351641246356261/351847826356262. 351641246356303/351847826356304. 351641246356410/35184782635641
1. 351641246356709/351847826356700. 351641246356733/351847826356734. 351641246356865/351847826356866. 351641246356873/35184782635
6874. 351641246356915/351847826356916. 351641246356956/351847826356957. 351641246357012/351847826357013. 351641246358242/35184782
6358243. 351641246358267/351847826358268. 351641246358283/351847826358284. 351641246358309/351847826358300. 351641246358341/35184
7826358342. 351641246358440/351847826358441. 351641246358473/351847826358474. 351641246358739/351847826358730. 351641246358853/35
1847826358854. 351641246358903/351847826358904. 351641246358911/351847826358912. 351641246358937/351847826358938. 351641246358952
/351847826358953. 351641246358978/351847826358979. 351641246359026/351847826359027. 351641246359042/351847826359043. 351641246359
067/351847826359068. 351641246359083/351847826359084. 351641246359133/351847826359134. 351641246359208/351847826359209. 351641246
359216/351847826359217. 351641246359299/351847826359290. 351641246359307/351847826359308.351641246359331/351847826359332. 3516412
46359356/351847826359357. 351641246359398/351847826359399. 351641246359422/351847826359423. 351641246359430/351847826359431. 3516
41246359471/351847826359472. 351641246359489/351847826359480. 351641246359497/351847826359498. 351641246359760/351847826359761. 3
51641246359844/351847826359845. 351641246360164/351847826360165. 351641246361089/351847826361080. 351641246361246/351847826361247
. 351641246361253/351847826361254. 351641246361279/351847826361270. 351641246361287/351847826361288. 351641246361352/351847826361
353.351641246361378/351847826361379. 351641246361394/351847826361395. 351641246361402/351847826361403. 351641246361410/3518478263
61411. 351641246361428/351847826361429. 351641246361444/351847826361445. 351641246361469/351847826361460. 351641246361477/3518478
26361478. 351641246361519/351847826361510. 351641246361527/351847826361528. 351641246361535/351847826361536. 351641246361642/3518
47826361643. 351641246361691/351847826361692. 351641246361709/351847826361700. 351641246361758/351847826361759. 351641246361766/3
51847826361767. 351641246361782/351847826361783. 351641246361873/351847826361874. 351641246361881/351847826361882. 35164124636189
9/351847826361890. 351641246361923/351847826361924. 351641246361956/351847826361957. 351641246361980/351847826361981. 35164124636
3804/351847826363805. 351641246363812/351847826363813. 351641246363820/351847826363821. 351641246363838/351847826363839. 35164124
6363846/351847826363847. 351641246363853/351847826363854. 351641246363861/351847826363862. 351641246363879/351847826363870. 35164
1246363887/351847826363888. 351641246363895/351847826363896. 351641246363903/351847826363904. 351641246363937/351847826363938. 35
1641246363945/351847826363946. 351641246363952/351847826363953. 351641246363960/351847826363961. 351641246364042/351847826364043.
351641246364059/351847826364050. 351641246364083/351847826364084. 351641246364141/351847826364142. 351641246364166/3518478263641
67. 351641246364174/351847826364175. 351641246364216/351847826364217. 351641246364224/351847826364225. 351641246364240/3518478263
64241. 351641246364265/351847826364266. 351641246364281/351847826364282. 351641246364315/351847826364316. 351641246364331/3518478
26364332. 351641246364356/351847826364357. 351641246364364/351847826364365.351641246364406/351847826364407. 351641246364422/35184
7826364423. 351641246364463/351847826364464. 351641246364489/351847826364480. 351641246364497/351847826364498. 351641246364505/35
1847826364506. 351641246364513/351847826364514. 351641246364521/351847826364522. 351641246364539/351847826364530. 351641246364554
/351847826364555. 351641246364562/351847826364563. 351641246364588/351847826364589. 351641246364596/351847826364597. 351641246364
604/351847826364605. 351641246364612/351847826364613. 351641246362004/351847826362005. 351641246362020/351847826362021.3516412463
62053/351847826362054. 351641246362079/351847826362070. 351641246362087/351847826362088. 351641246362095/351847826362096. 3516412
46362111/351847826362112. 351641246362129/351847826362120. 351641246362145/351847826362146. 351641246362152/351847826362153. 3516
41246362160/351847826362161. 351641246362178/351847826362179. 351641246362194/351847826362195. 351641246362228/351847826362229. 3
51641246362236/351847826362237. 351641246362251/351847826362252. 351641246362269/351847826362260. 351641246362277/351847826362278
. 351641246362285/351847826362286. 351641246362293/351847826362294. 351641246362301/351847826362302. 351641246362319/351847826362
310. 351641246362327/351847826362328. 351641246362335/351847826362336. 351641246362343/351847826362344. 351641246362350/351847826
362351. 351641246362368/351847826362369. 351641246362376/351847826362377. 351641246362384/351847826362385. 351641246362392/351847
826362393. 351641246362400/351847826362401. 351641246362418/351847826362419. 351641246362426/351847826362427. 351641246362442/351
847826362443. 351641246362459/351847826362450. 351641246362475/351847826362476. 351641246362491/351847826362492. 351641246362509/
351847826362500. 351641246362517/351847826362518. 351641246362525/351847826362526. 351641246362533/351847826362534. 3516412463625
41/351847826362542. 351641246362558/351847826362559. 351641246362566/351847826362567. 351641246362574/351847826362575. 3516412463
62582/351847826362583. 351641246362590/351847826362591. 351641246362608/351847826362609. 351641246362616/351847826362617. 3516412
46362624/351847826362625. 351641246362657/351847826362658. 351641246362673/351847826362674. 351641246362681/351847826362682. 3516
41246362699/351847826362690. 351641246362707/351847826362708.351641246362715/351847826362716. 351641246362731/351847826362732. 35
1641246362749/351847826362740. 351641246362756/351847826362757. 351641246362764/351847826362765. 351641246362772/351847826362773.
351641246362814/351847826362815. 351641246362822/351847826362823. 351641246362830/351847826362831. 351641246362848/3518478263628
49. 351641246362855/351847826362856. 351641246362863/351847826362864. 351641246362871/351847826362872. 351641246362889/3518478263
62880. 351641246362897/351847826362898. 351641246362905/351847826362906. 351641246362913/351847826362914.351641246362921/35184782
6362922. 351641246362939/351847826362930. 351641246362947/351847826362948. 351641246362970/351847826362971. 351641246362988/35184
7826362989. 351641246362996/351847826362997. 351641246363002/351847826363003. 351641246363028/351847826363029. 351641246363036/35
1847826363037. 351641246363044/351847826363045. 351641246363051/351847826363052. 351641246363069/351847826363060. 351641246363077
/351847826363078. 351641246363085/351847826363086. 351641246363119/351847826363110. 351641246363127/351847826363128. 351641246363
135/351847826363136. 351641246363150/351847826363151. 351641246363168/351847826363169. 351641246363184/351847826363185. 351641246
363192/351847826363193. 351641246363218/351847826363219. 351641246363226/351847826363227. 351641246363234/351847826363235. 351641
246363242/351847826363243. 351641246363259/351847826363250. 351641246363267/351847826363268. 351641246363275/351847826363276. 351
641246363283/351847826363284. 351641246363291/351847826363292. 351641246363309/351847826363300. 351641246363317/351847826363318.
032025000867234-7
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000867234-7
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
351641246363325/351847826363326. 351641246363333/351847826363334. 351641246363341/351847826363342. 351641246363358/35184782636335
9. 351641246363366/351847826363367. 351641246363382/351847826363383. 351641246363390/351847826363391. 351641246363408/35184782636
3409. 351641246363416/351847826363417. 351641246363424/351847826363425. 351641246363432/351847826363433. 351641246363440/35184782
6363441. 351641246363465/351847826363466. 351641246363473/351847826363474. 351641246363507/351847826363508. 351641246363523/35184
7826363524. 351641246363564/351847826363565. 351641246363572/351847826363573. 351641246363580/351847826363581. 351641246363606/35
1847826363607. 351641246363614/351847826363615.351641246363622/351847826363623. 351641246363630/351847826363631. 351641246363655/
351847826363656. 351641246363705/351847826363706. 351641246363713/351847826363714. 351641246363721/351847826363722. 3516412463637
47/351847826363748. 351641246363762/351847826363763. 351641246363770/351847826363771. 351641246363788/351847826363789. 3516412463
64620/351847826364621. 351641246364638/351847826364639. 351641246364646/351847826364647. 351641246364653/351847826364654. 3516412
46364661/351847826364662. 351641246364687/351847826364688. 351641246364695/351847826364696.351641246364703/351847826364704. 35164
1246364711/351847826364712. 351641246364729/351847826364720. 351641246364737/351847826364738. 351641246364745/351847826364746. 35
1641246364752/351847826364753. 351641246364760/351847826364761. 351641246364778/351847826364779. 351641246364786/351847826364787.
351641246364802/351847826364803. 351641246364828/351847826364829. 351641246364844/351847826364845. 351641246364851/3518478263648
52. 351641246364869/351847826364860. 351641246364877/351847826364878. 351641246364885/351847826364886. 351641246364893/3518478263
64894. 351641246364901/351847826364902. 351641246364919/351847826364910. 351641246364950/351847826364951. 351641246364968/3518478
26364969. 351641246364976/351847826364977. 351641246365007/351847826365008. 351641246365031/351847826365032. 351641246365049/3518
47826365040. 351641246365056/351847826365057. 351641246365064/351847826365065. 351641246365098/351847826365099. 351641246365130/3
51847826365131. 351641246365148/351847826365149. 351641246365171/351847826365172. 351641246365197/351847826365198. 35164124636525
4/351847826365255. 351641246365270/351847826365271. 351641246365304/351847826365305. 351641246365312/351847826365313. 35164124636
5320/351847826365321. 351641246365338/351847826365339. 351641246365346/351847826365347. 351641246365361/351847826365362. 35164124
6365379/351847826365370. 351641246365387/351847826365388. 351641246365429/351847826365420. 351641246365437/351847826365438. 35164
1246365452/351847826365453. 351641246365551/351847826365552. 351641246365577/351847826365578. 351641246365619/351847826365610. 35
1641246365635/351847826365636. 351641246365643/351847826365644. 351641246365692/351847826365693. 351641246365700/351847826365701.
351641246365718/351847826365719.351641246365726/351847826365727. 351641246365734/351847826365735. 351641246365742/35184782636574
3. 351641246365759/351847826365750. 351641246365809/351847826365800. 351641246365817/351847826365818. 351641246365866/35184782636
5867. 351641246365890/351847826365891. 351641246365908/351847826365909. 351641246365916/351847826365917. 351641246365924/35184782
6365925. 351641246365981/351847826365982. 351641246365999/351847826365990. 351641246366005/351847826366006. 351641246366013/35184
7826366014. 351641246366021/351847826366022. 351641246366054/351847826366055.351641246366070/351847826366071. 351641246366088/351
847826366089. 351641246366096/351847826366097. 351641246366104/351847826366105. 351641246366138/351847826366139. 351641246366146/
351847826366147. 351641246366195/351847826366196. 351641246366211/351847826366212. 351641246366229/351847826366220. 3516412463662
37/351847826366238. 351641246366245/351847826366246. 351641246366260/351847826366261. 351641246366286/351847826366287. 3516412463
42444/351847826342445. 351641246345975/351847826345976. 351641246345991/351847826345992. 351641246346049/351847826346040. 3516412
46346064/351847826346065. 351641246346072/351847826346073. 351641246346270/351847826346271. 351641246346304/351847826346305. 3516
41246346312/351847826346313. 351641246346320/351847826346321. 351641246346338/351847826346339. 351641246346346/351847826346347. 3
51641246346353/351847826346354. 351641246346361/351847826346362. 351641246346379/351847826346370. 351641246346387/351847826346388
. 351641246346395/351847826346396. 351641246346429/351847826346420. 351641246347518/351847826347519. 351641246349217/351847826349
218. 351641246350264/351847826350265. 351641246351148/351847826351149. 351641246351304/351847826351305. 351641246351627/351847826
351628. 351641246352468/351847826352469. 351641246352989/351847826352980. 351641246353169/351847826353160. 351641246353235/351847
826353236. 351641246353367/351847826353368. 351641246353649/351847826353640. 351641246354258/351847826354259. 351641246354480/351
847826354481. 351641246354498/351847826354499. 351641246354506/351847826354507. 351641246354530/351847826354531. 351641246354548/
351847826354549. 351641246354639/351847826354630. 351641246354647/351847826354648. 351641246354670/351847826354671. 3516412463546
88/351847826354689.351641246354761/351847826354762. 351641246354779/351847826354770. 351641246354795/351847826354796. 35164124635
4803/351847826354804. 351641246354811/351847826354812. 351641246366294/351847826366295. 351641246366302/351847826366303. 35164124
6366385/351847826366386. 351641246366427/351847826366428. 351641246366559/351847826366550. 351641246366583/351847826366584. 35164
1246366617/351847826366618. 351641246366625/351847826366626. 351641246366633/351847826366634. 351641246366658/351847826366659. 35
1641246366690/351847826366691. 351641246366708/351847826366709.351641246366716/351847826366717. 351641246366724/351847826366725.
351641246366757/351847826366758. 351641246366765/351847826366766. 351641246367052/351847826367053. 351641246367110/35184782636711
1. 351641246367136/351847826367137. 351641246367144/351847826367145. 351641246367151/351847826367152. 351641246367219/35184782636
7210. 351641246367243/351847826367244. 351641246367250/351847826367251. 351641246367268/351847826367269. 351641246367292/35184782
6367293. 351641246367326/351847826367327. 351641246367334/351847826367335. 351641246367367/351847826367368. 351641246367375/35184
7826367376. 351641246367391/351847826367392. 351641246367409/351847826367400. 351641246367417/351847826367418. 351641246367425/35
1847826367426. 351641246367433/351847826367434. 351641246367441/351847826367442. 351641246367458/351847826367459. 351641246367466
/351847826367467. 351641246367482/351847826367483. 351641246367490/351847826367491. 351641246367508/351847826367509. 351641246367
516/351847826367517. 351641246367532/351847826367533. 351641246367540/351847826367541. 351641246367565/351847826367566XXXXXXXXXXX
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032025000867234-7
Espacio para uso exclusivo de la Entidad Recaudadora
Page 3
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
032025000020687-4
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
102294385
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. 116575015148198
43 . Año – Mes – Día
2025 – 01 – 08
44 . Documento de transporte
No. 41N0691515
45 . Año – Mes – Día
2025 – 01 – 01
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
6900328780
52 . Año – Mes – Día
2024 – 12 – 25
53 . Cod. país
procedencia
351
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.
4.410.50
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
01
69 . Tipo de
importación
01
70 . Cod. país
compra
190
71 . Peso bruto kgs. dcms.
108.00
72 . Peso neto kgs. dcms.
78.59
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
290.00
78 .Valor FOB
USD
14.389.47
79 . Valor fletes USD
870.48 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
67.307.273
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
67.307.273
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
0.74
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
871.22
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
15.260.69
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: 543197-DECL: 1873521-DO: 893100014251- 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: 3080696620. ID DELIVERY: 6079778556. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MLGGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE CLA(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
032025000020687
133. Feha: 202501 07
134 . Levante No. 032025000028603 135 . Fecha
2025 – 01 – 09
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 92032500127928
Fecha presentación 2025-01-07 18:38:31
Valor pagado $0.00
Fecha de Impresión: 2025-01-09 14:05:23
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000020687-4
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
RO, MODELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,LIGHT GREEN,LTC( QTY. 290,00 u )(2
90,00 PCE); IMEIS: 351641243019904/351847823019905. 351641243019953/351847823019954. 351641243037237/351847823037238. 35164124304
2112/351847823042113. 351641243043920/351847823043921. 351641243043995/351847823043996. 351641243044084/351847823044085. 35164124
3044092/351847823044093. 351641243044100/351847823044101. 351641243044191/351847823044192. 351641243044233/351847823044234. 35164
1243044316/351847823044317. 351641243044399/351847823044390.351641243044605/351847823044606. 351641243044639/351847823044630. 351
641243045784/351847823045785. 351641243045958/351847823045959. 351641243046618/351847823046619. 351641243048804/351847823048805.
351641243049075/351847823049076. 351641243049356/351847823049357. 351641243049729/351847823049720. 351641243049752/35184782304975
3. 351641243049794/351847823049795. 351641243049802/351847823049803. 351641243049992/3518478 23049993. 351641243050156/3518478230
50157. 351641243050222/351847823050223. 351641243050305/351847823050306. 351641243050354/351847823050355. 351641243050404/3518478
23050405. 351641243050412/351847823050413. 351641243050610/351847823050611. 351641243050735/351847823050736. 351641243050818/3518
47823050819. 351641243050834/351847823050835. 351641243050990/351847823050991. 351641243051188/351847823051189. 351641243051295/3
51847823051296. 351641243051543/351847823051544. 351641243051659/351847823051650. 351641243051790/351847823051791. 35164124305192
3/351847823051924. 351641243051980/351847823051981. 351641243052012/351847823052013. 351641243052244/351847823052245. 35164124305
2251/351847823052252. 351641243052343/351847823052344. 351641243052368/351847823052369. 351641243052533/351847823052534. 35164124
3052632/351847823052633. 351641243053077/351847823053078. 351641243053085/351847823053086. 351641243053622/351847823053623. 35164
1243053788/351847823053789. 351641243053796/351847823053797. 351641243054224/351847823054225. 351641243054273/351847823054274. 35
1641243054307/351847823054308. 351641243054349/351847823054340. 351641243054364/351847823054365. 351641243054505/351847823054506.
351641243054562/351847823054563. 351641243054588/351847823054589. 351641243054604/351847823054605. 351641243054653/3518478230546
54.351641243054661/351847823054662. 351641243054687/351847823054688. 351641243054711/351847823054712. 351641243054752/35184782305
4753. 351641243054794/351847823054795. 351641243054802/351847823054803. 351641243054851/351847823054852. 351641243054919/35184782
3054910. 351641243054984/351847823054985. 351641243055007/351847823055008. 351641243055015/351847823055016. 351641243055197/35184
7823055198. 351641243055213/351847823055214. 351641243055320/351847823055321. 351641243055338/351847823055339. 351641243055429/35
1847823055420. 351641243055585/351847823055586.351641243055650/351847823055651. 351641243055700/351847823055701. 351641243055775/
351847823055776. 351641243055833/351847823055834. 351641243055882/351847823055883. 351641243056054/351847823056055. 3516412430562
37/351847823056238. 351641243056278/351847823056279. 351641243056294/351847823056295. 351641243056369/351847823056360. 3516412430
56377/351847823056378. 351641243056393/351847823056394. 351641243056419/351847823056410. 351641243056427/351847823056428. 3516412
43056435/351847823056436. 351641243056443/351847823056444. 351641243056450/351847823056451. 351641243056492/351847823056493. 3516
41243056500/351847823056501. 351641243056518/351847823056519. 351641243056526/351847823056527. 351641243056534/351847823056535. 3
51641243056542/351847823056543. 351641243056567/351847823056568. 351641243056575/351847823056576. 351641243056583/351847823056584
. 351641243056591/351847823056592. 351641243056609/351847823056600. 351641243056625/351847823056626. 351641243056633/351847823056
634. 351641243056658/351847823056659. 351641243056666/351847823056667. 351641243056674/351847823056675. 351641243056682/351847823
056683. 351641243056690/351847823056691. 351641243056708/351847823056709. 351641243056716/351847823056717. 351641243056724/351847
823056725. 351641243056732/351847823056733. 351641243056740/351847823056741. 351641243056757/351847823056758. 351641243056765/351
847823056766. 351641243056773/351847823056774. 351641243056781/351847823056782. 351641243056799/351847823056790. 351641243056807/
351847823056808. 351641243056815/351847823056816. 351641243056823/351847823056824. 351641243056831/351847823056832. 3516412430568
49/351847823056840. 351641243056864/351847823056865. 351641243056872/351847823056873. 351641243056880/351847823056881.35164124305
6898/351847823056899. 351641243056906/351847823056907. 351641243056914/351847823056915. 351641243056922/351847823056923. 35164124
3056930/351847823056931. 351641243056948/351847823056949. 351641243056955/351847823056956. 351641243056963/351847823056964. 35164
1243056997/351847823056998. 351641243057003/351847823057004. 351641243057011/351847823057012. 351641243057029/351847823057020. 35
1641243057037/351847823057038. 351641243057045/351847823057046. 351641243057060/351847823057061. 351641243057078/351847823057079.
351641243057086/351847823057087.351641243057094/351847823057095. 351641243057110/351847823057111. 351641243057128/35184782305712
9. 351641243057136/351847823057137. 351641243057144/351847823057145. 351641243057151/351847823057152. 351641243057219/35184782305
7210. 351641243057300/351847823057301. 351641243057326/351847823057327. 351641243057334/351847823057335. 351641243057342/35184782
3057343. 351641243057359/351847823057350. 351641243057375/351847823057376. 351641243057391/351847823057392. 351641243057409/35184
7823057400. 351641243057417/351847823057418. 351641243057425/351847823057426. 351641243057433/351847823057434. 351641243057466/35
1847823057467. 351641243057474/351847823057475. 351641243057508/351847823057509. 351641243057516/351847823057517. 351641243057524
/351847823057525. 351641243057532/351847823057533. 351641243057557/351847823057558. 351641243057565/351847823057566. 351641243057
599/351847823057590. 351641243058571/351847823058572. 351641243058589/351847823058580. 351641243058597/351847823058598. 351641243
058605/351847823058606. 351641243058613/351847823058614. 351641243058621/351847823058622. 351641243058639/351847823058630. 351641
243058647/351847823058648. 351641243058654/351847823058655. 351641243058662/351847823058663. 351641243058670/351847823058671. 351
641243058688/351847823058689. 351641243058696/351847823058697. 351641243058704/351847823058705. 351641243058712/351847823058713.
351641243058720/351847823058721. 351641243058738/351847823058739. 351641243058746/351847823058747. 351641243058753/35184782305875
4. 351641243058761/351847823058762. 351641243057607/351847823057608. 351641243057623/351847823057624. 351641243057631/35184782305
7632. 351641243057656/351847823057657. 351641243057664/351847823057665. 351641243057672/351847823057673.351641243057680/351847823
057681. 351641243057714/351847823057715. 351641243057722/351847823057723. 351641243057730/351847823057731. 351641243057748/351847
823057749. 351641243057755/351847823057756. 351641243057763/351847823057764. 351641243057771/351847823057772. 351641243057789/351
847823057780. 351641243057797/351847823057798. 351641243057805/351847823057806. 351641243057813/351847823057814. 351641243057821/
351847823057822. 351641243057839/351847823057830. 351641243057847/351847823057848. 351641243057854/351847823057855. 3516412430578
62/351847823057863.351641243057870/351847823057871. 351641243057896/351847823057897. 351641243057904/351847823057905. 35164124305
7912/351847823057913. 351641243057920/351847823057921. 351641243057938/351847823057939. 351641243057946/351847823057947. 35164124
3057953/351847823057954. 351641243057961/351847823057962. 351641243057979/351847823057970. 351641243057987/351847823057988. 35164
1243057995/351847823057996. 351641243058001/351847823058002. 351641243058019/351847823058010. 351641243058027/351847823058028. 35
1641243058035/351847823058036. 351641243058043/351847823058044. 351641243058050/351847823058051. 351641243058068/351847823058069.
351641243058076/351847823058077. 351641243058084/351847823058085. 351641243058092/351847823058093. 351641243058100/3518478230581
01. 351641243058118/351847823058119. 351641243058126/351847823058127. 351641243058134/351847823058135. 351641243058142/3518478230
58143. 351641243058159/351847823058150. 351641243058167/351847823058168. 351641243058175/351847823058176. 351641243058183/3518478
23058184. 351641243058191/351847823058192. 351641243058209/351847823058200. 351641243058217/351847823058218. 351641243058225/3518
47823058226. 351641243058233/351847823058234. 351641243058241/351847823058242. 351641243058258/351847823058259. 351641243058266/3
51847823058267. 351641243058274/351847823058275. 351641243058290/351847823058291. 351641243058308/351847823058309. 35164124305831
6/351847823058317. 351641243058324/351847823058325. 351641243058332/351847823058333. 351641243058340/351847823058341. 35164124305
8357/351847823058358. 351641243058365/351847823058366. 351641243058373/351847823058374. 351641243058381/351847823058382. 35164124
3058399/351847823058390. 351641243058407/351847823058408. 351641243058415/351847823058416.351641243058423/351847823058424. 351641
243058431/351847823058432. 351641243058449/351847823058440. 351641243058456/351847823058457. 351641243058464/351847823058465. 351
641243058472/351847823058473. 351641243058480/351847823058481. 351641243058498/351847823058499. 351641243058506/351847823058507.
351641243058514/351847823058515. 351641243058522/351847823058523. 351641243058530/351847823058531. 351641243058548/35184782305854
032025000020687-4
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000020687-4
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
9. 351641243058555/351847823058556XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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