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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
032025001881676-0
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. 116575016213568
43 . Año – Mes – Día
2025 – 10 – 26
44 . Documento de transporte
No. SHAN0433120
45 . Año – Mes – Día
2025 – 10 – 21
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
9103871625
52 . Año – Mes – Día
2025 – 10 – 21
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.
3.877.07
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.
159.50
72 . Peso neto kgs. dcms.
126.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
450.00
78 .Valor FOB
USD
84.755.87
79 . Valor fletes USD
1.370.11 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
333.927.464
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
333.927.464
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
2.84
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.372.95
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
86.128.82
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: 578157-DECL: 1966799-DO: 893126464251- 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: 3102008860. ID DELIVERY: 6085218155. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A366ELGGLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A36 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE CL(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
032025001881676
133. Feha: 202510 24
134 . Levante No. 032025001615198 135 . Fecha
2025 – 10 – 28
Firma funcionario responsable 136 . Nombre
137 . C.C. No.
Firma declarante 997 . Espacio exclusivo para el sello
de la entidad recaudadora
(Fecha efectiva de la transacción)
Coloque el timbre de la máquina
registradora al dorso de este formulario
980 . Pago Total $
0
996 . Espacio para autoadhesivo de la entidad recaudadora
(Número del adhesivo)
SYGA
Autoadhesivo 92032508376906
Fecha presentación 2025-10-24 17:48:02
Valor pagado $0.00
Fecha de Impresión: 2025-10-28 08:36:33
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001881676-0
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ARO,MODELO: SM-A366E/DS,USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE, SM-A366E/DS,LIGHT GREEN,LTC( QTY. 450,00 u )(4
50,00 PCE ); IMEIS: 352041713178398/354704243178398. 352041713178455/354704243178455. 352041713178463/354704243178463. 3520417131
78505/354704243178505. 352041713178547/354704243178547. 352041713178562/354704243178562. 352041713178570/354704243178570. 3520417
13178588/354704243178588. 352041713178703/354704243178703. 352041713178760/354704243178760. 352041713178869/354704243178869. 3520
41713178877/354704243178877. 352041713178943/354704243178943. 352041713178968/354704243178968. 352041713179024/354704243179024. 3
52041713179156/354704243179156. 352041713179271/354704243179271. 352041713179321/354704243179321. 352041713179354/354704243179354
. 352041713179362/354704243179362. 352041713179388/354704243179388. 352041713179396/354704243179396. 352041713179404/354704243179
404. 352041713179412/354704243179412. 352041713179438/354704243179438. 352041713179461/35470 4243179461. 352041713179479/35470424
3179479. 352041713179487/354704243179487. 352041713179693/354704243179693. 352041713179735/354704243179735. 352041713179818/35470
4243179818. 352041713179826/354704243179826.352041713179859/354704243179859. 352041713179867/354704243179867. 352041713179917/354
704243179917. 352041713179941/354704243179941. 352041713179990/354704243179990. 352041713180014/354704243180014. 352041713180030/
354704243180030. 352041713180048/354704243180048. 352041713180071/354704243180071. 352041713180147/354704243180147. 3520417131801
62/354704243180162. 352041713180220/354704243180220. 352041713180246/354704243180246. 352041713180378/354704243180378. 3520417131
80444/354704243180444. 352041713180501/354704243180501. 352041713180584/354704243180584.352041713180600/354704243180600. 35204171
3180626/354704243180626. 352041713180642/354704243180642. 352041713180667/354704243180667. 352041713180675/354704243180675. 35204
1713180683/354704243180683. 352041713180709/354704243180709. 352041713180717/354704243180717. 352041713180725/354704243180725. 35
2041713180774/354704243180774. 352041713180790/354704243180790. 352041713180808/354704243180808. 352041713180824/354704243180824.
352041713180840/354704243180840. 352041713180899/354704243180899. 352041713180931/354704243180931. 352041713180949/3547042431809
49. 352041713180964/354704243180964. 352041713180972/354704243180972. 352041713181087/354704243181087. 352041713181103/3547042431
81103. 352041713181111/354704243181111. 352041713181145/354704243181145. 352041713181152/354704243181152. 352041713181228/3547042
43181228. 352041713181244/354704243181244. 352041713181251/354704243181251. 352041713181269/354704243181269. 352041713181301/3547
04243181301. 352041713181426/354704243181426. 352041713181459/354704243181459. 352041713181475/354704243181475. 352041713181509/3
54704243181509. 352041713181533/354704243181533. 352041713181558/354704243181558. 352041713181657/354704243181657. 35204171318168
1/354704243181681. 352041713181699/354704243181699. 352041713181723/354704243181723. 352041713181814/354704243181814. 35204171318
1855/354704243181855. 352041713181863/354704243181863. 352041713182028/354704243182028. 352041713182093/354704243182093. 35204171
3182101/354704243182101. 352041713182143/354704243182143. 352041713182184/354704243182184. 352041713182218/354704243182218. 35204
1713182242/354704243182242. 352041713182259/354704243182259. 352041713182283/354704243182283. 352041713182291/354704243182291. 35
2041713182317/354704243182317.352041713182333/354704243182333. 352041713182341/354704243182341. 352041713182358/354704243182358.
352041713182366/354704243182366. 352041713182374/354704243182374. 352041713182382/354704243182382. 352041713182390/35470424318239
0. 352041713182408/354704243182408. 352041713182416/354704243182416. 352041713182432/354704243182432. 352041713182440/35470424318
2440. 352041713182457/354704243182457. 352041713182481/354704243182481. 352041713182507/354704243182507. 352041713182515/35470424
3182515. 352041713183018/354704243183018. 352041713183075/354704243183075.352041713183554/354704243183554. 352041713184784/354704
243184784. 352041713185195/354704243185195. 352041713185336/354704243185336. 352041713185435/354704243185435. 352041713185476/354
704243185476. 352041713185492/354704243185492. 352041713185542/354704243185542. 352041713185575/354704243185575. 352041713185633/
354704243185633. 352041713185690/354704243185690. 352041713185716/354704243185716. 352041713185757/354704243185757. 3520417131857
81/354704243185781. 352041713185799/354704243185799. 352041713185807/354704243185807. 352041713185815/354704243185815. 3520417131
85856/354704243185856. 352041713185864/354704243185864. 352041713185872/354704243185872. 352041713185880/354704243185880. 3520417
13185898/354704243185898. 352041713185914/354704243185914. 352041713185922/354704243185922. 352041713185930/354704243185930. 3520
41713185948/354704243185948. 352041713185955/354704243185955. 352041713185963/354704243185963. 352041713185971/354704243185971. 3
52041713185989/354704243185989. 352041713186003/354704243186003. 352041713186011/354704243186011. 352041713186029/354704243186029
. 352041713186037/354704243186037. 352041713186045/354704243186045. 352041713186060/354704243186060. 352041713186078/354704243186
078. 352041713186094/354704243186094. 352041713186102/354704243186102. 352041713186110/354704243186110. 352041713186128/354704243
186128. 352041713186136/354704243186136. 352041713186144/354704243186144. 352041713186177/354704243186177. 352041713186193/354704
243186193. 352041713186201/354704243186201. 352041713186219/354704243186219. 352041713186243/354704243186243. 352041713186250/354
704243186250. 352041713186292/354704243186292. 352041713186300/354704243186300. 352041713186334/354704243186334. 352041713186359/
354704243186359.352041713186367/354704243186367. 352041713186375/354704243186375. 352041713186441/354704243186441. 35204171318647
4/354704243186474. 352041713186516/354704243186516. 352041713186615/354704243186615. 352041713186656/354704243186656. 35204171318
6714/354704243186714. 352041713186755/354704243186755. 352041713186771/354704243186771. 352041713186789/354704243186789. 35204171
3186797/354704243186797. 352041713186805/354704243186805. 352041713186813/354704243186813. 352041713186839/354704243186839. 35204
1713186862/354704243186862. 352041713186870/354704243186870.352041713186888/354704243186888. 352041713186938/354704243186938. 352
041713186961/354704243186961. 352041713186979/354704243186979. 352041713186987/354704243186987. 352041713186995/354704243186995.
352041713187001/354704243187001. 352041713187019/354704243187019. 352041713187027/354704243187027. 352041713187035/35470424318703
5. 352041713187068/354704243187068. 352041713187076/354704243187076. 352041713187084/354704243187084. 352041713187092/35470424318
7092. 352041713187100/354704243187100. 352041713187118/354704243187118. 352041713187134/354704243187134. 352041713187142/35470424
3187142. 352041713187175/354704243187175. 352041713187183/354704243187183. 352041713187191/354704243187191. 352041713187209/35470
4243187209. 352041713187217/354704243187217. 352041713187241/354704243187241. 352041713187258/354704243187258. 352041713187266/35
4704243187266. 352041713187274/354704243187274. 352041713187282/354704243187282. 352041713187290/354704243187290. 352041713187308
/354704243187308. 352041713187316/354704243187316. 352041713187324/354704243187324. 352041713187332/354704243187332. 352041713187
340/354704243187340. 352041713187365/354704243187365. 352041713187381/354704243187381. 352041713187399/354704243187399. 352041713
187407/354704243187407. 352041713187423/354704243187423. 352041713187449/354704243187449. 352041713187456/354704243187456. 352041
713187464/354704243187464. 352041713187472/354704243187472. 352041713187480/354704243187480. 352041713187514/354704243187514. 352
041713187530/354704243187530. 352041713187548/354704243187548. 352041713187563/354704243187563. 352041713187571/354704243187571.
352041713187647/354704243187647. 352041713187670/354704243187670. 352041713187753/354704243187753. 352041713187787/35470424318778
7.352041713187795/354704243187795. 352041713187878/354704243187878. 352041713187886/354704243187886. 352041713187894/354704243187
894. 352041713187936/354704243187936. 352041713187977/354704243187977. 352041713188017/354704243188017. 352041713188074/354704243
188074. 352041713188090/354704243188090. 352041713188181/354704243188181. 352041713188256/354704243188256. 352041713188355/354704
243188355. 352041713188496/354704243188496. 352041713188504/354704243188504. 352041713188538/354704243188538. 352041713188546/354
704243188546. 352041713188553/354704243188553.352041713188579/354704243188579. 352041713188587/354704243188587. 352041713188769/3
54704243188769. 352041713188850/354704243188850. 352041713188983/354704243188983. 352041713189148/354704243189148. 35204171318915
5/354704243189155. 352041713189700/354704243189700. 352041713189718/354704243189718. 352041713189734/354704243189734. 35204171318
9783/354704243189783. 352041713189809/354704243189809. 352041713189817/354704243189817. 352041713189858/354704243189858. 35204171
3189916/354704243189916. 352041713189924/354704243189924. 352041713189932/354704243189932. 352041713190005/354704243190005. 35204
1713190013/354704243190013. 352041713190021/354704243190021. 352041713190039/354704243190039. 352041713190062/354704243190062. 35
2041713190070/354704243190070. 352041713190088/354704243190088. 352041713190096/354704243190096. 352041713190112/354704243190112.
352041713190146/354704243190146. 352041713190153/354704243190153. 352041713190179/354704243190179. 352041713190187/3547042431901
032025001881676-0
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001881676-0
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
87. 352041713190195/354704243190195. 352041713190203/354704243190203. 352041713190211/354704243190211. 352041713190229/3547042431
90229. 352041713190237/354704243190237. 352041713190245/354704243190245. 352041713190252/354704243190252. 352041713190260/3547042
43190260. 352041713190278/354704243190278. 352041713190294/354704243190294. 352041713190328/354704243190328. 352041713190336/3547
04243190336. 352041713190351/354704243190351. 352041713190377/354704243190377. 352041713190484/354704243190484. 352041713190500/3
54704243190500. 352041713190518/354704243190518. 352041713190526/354704243190526. 352041713190534/354704243190534. 35204171319054
2/354704243190542. 352041713190575/354704243190575. 352041713190609/354704243190609. 352041713190617/354704243190617.352041713190
641/354704243190641. 352041713190708/354704243190708. 352041713190724/354704243190724. 352041713190732/354704243190732. 352041713
190740/354704243190740. 352041713190757/354704243190757. 352041713190765/354704243190765. 352041713190773/354704243190773. 352041
713190823/354704243190823. 352041713190880/354704243190880. 352041713190989/354704243190989. 352041713190997/354704243190997. 352
041713191003/354704243191003. 352041713191029/354704243191029. 352041713191037/354704243191037. 352041713191052/354704243191052.
352041713191094/354704243191094.352041713191169/354704243191169. 352041713191201/354704243191201. 352041713191268/354704243191268
. 352041713191300/354704243191300. 352041713191318/354704243191318. 352041713191326/354704243191326. 352041713191342/354704243191
342. 352041713191359/354704243191359. 352041713191367/354704243191367. 352041713191383/354704243191383. 352041713191391/354704243
191391. 352041713191417/354704243191417. 352041713191425/354704243191425. 352041713191433/354704243191433. 352041713191441/354704
243191441. 352041713191458/354704243191458. 352041713191474/354704243191474. 352041713191482/354704243191482. 352041713191490/354
704243191490. 352041713191516/354704243191516. 352041713191540/354704243191540. 352041713191565/354704243191565. 352041713191573/
354704243191573. 352041713191581/354704243191581. 352041713191599/354704243191599. 352041713191672/354704243191672. 3520417131917
06/354704243191706. 352041713191722/354704243191722. 352041713191805/354704243191805. 352041713191870/354704243191870. 3520417131
91888/354704243191888. 352041713191904/354704243191904. 352041713192027/354704243192027. 352041713192035/354704243192035. 3520417
13192050/354704243192050. 352041713192092/354704243192092. 352041713192159/354704243192159. 352041713192167/354704243192167. 3520
41713192266/354704243192266. 352041713192274/354704243192274. 352041713192308/354704243192308. 352041713192316/354704243192316. 3
52041713192332/354704243192332. 352041713192357/354704243192357. 352041713192365/354704243192365. 352041713192373/354704243192373
. 352041713192381/354704243192381. 352041713192399/354704243192399. 352041713192977/354704243192977. 352041713193520/354704243193
520. 352041713193553/354704243193553. 352041713193561/354704243193561. 352041713193579/354704243193579.352041713193587/3547042431
93587. 352041713193595/354704243193595. 352041713193637/354704243193637. 352041713193645/354704243193645. 352041713193801/3547042
43193801. 352041713193819/354704243193819. 352041713193850/354704243193850. 352041713193868/354704243193868. 352041713193876/3547
04243193876. 352041713193884/354704243193884. 352041713193983/354704243193983. 352041713194015/354704243194015. 352041713194031/3
54704243194031. 352041713194049/354704243194049. 352041713194056/354704243194056. 352041713194072/354704243194072. 35204171319410
6/354704243194106.352041713194122/354704243194122. 352041713194155/354704243194155. 352041713194163/354704243194163. 352041713194
197/354704243194197. 352041713194213/354704243194213. 352041713194270/354704243194270. 352041713194338/354704243194338. 352041713
194346/354704243194346. 352041713194353/354704243194353. 352041713194387/354704243194387. 352041713194411/354704243194411. 352041
713194429/354704243194429. 352041713194437/354704243194437. 352041713194445/354704243194445. 352041713194452/354704243194452. 352
041713194460/354704243194460. 352041713194478/354704243194478. 352041713194502/354704243194502. 352041713194536/354704243194536.
352041713194544/354704243194544. 352041713194601/354704243194601. 352041713194619/354704243194619. 352041713194650/35470424319465
0. 352041713194668/354704243194668. 352041713194775/354704243194775. 352041713195012/354704243195012. 352041713195228/35470424319
5228. 352041713195657/354704243195657. 352041713195764/354704243195764. 352041713195780/354704243195780. 352041713195897/35470424
3195897. 352041713195939/354704243195939. 352041713196069/354704243196069. 352041713196085/354704243196085. 352041713196119/35470
4243196119. 352041713196143/354704243196143. 352041713196200/354704243196200. 352041713196234/354704243196234. 352041713196275/35
4704243196275. 352041713196317/354704243196317. 352041713196366/354704243196366. 352041713196374/354704243196374. 352041713196416
/354704243196416. 352041713216313/354704243216313. 352041713216420/354704243216420. 352041713216487/354704243216487. 352041713216
495/354704243216495. 352041713216511/354704243216511. 352041713216586/354704243216586. 352041713216602/354704243216602. 352041713
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032025001881676-0
Espacio para uso exclusivo de la Entidad Recaudadora
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