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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
032025001881804-7
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. 116575016213568
43 . Año – Mes – Día
2025 – 10 – 26
44 . Documento de transporte
No. SHAN0433121
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
9103871626
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: 578159-DECL: 1966801-DO: 893126465251- 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: 3102007794. ID DELIVERY: 6085217756. 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
032025001881804
133. Feha: 202510 24
134 . Levante No. 032025001615212 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 92032508377699
Fecha presentación 2025-10-24 18:05:54
Valor pagado $0.00
Fecha de Impresión: 2025-10-28 08:38:19
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001881804-7
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: 352041713178349/354704243178349. 352041713178364/354704243178364. 352041713178414/354704243178414. 3520417131
78422/354704243178422. 352041713178430/354704243178430. 352041713178489/354704243178489. 352041713178604/354704243178604. 3520417
13178612/354704243178612. 352041713178646/354704243178646. 352041713178653/354704243178653. 352041713178661/354704243178661. 3520
41713178679/354704243178679. 352041713178695/354704243178695. 352041713178711/354704243178711. 352041713178729/354704243178729. 3
52041713178752/354704243178752. 352041713178778/354704243178778. 352041713178786/354704243178786. 352041713178794/354704243178794
. 352041713178802/354704243178802. 352041713178828/354704243178828. 352041713178836/354704243178836. 352041713178885/354704243178
885. 352041713178893/354704243178893. 352041713178919/354704243178919. 352041713178935/35470 4243178935. 352041713179768/35470424
3179768. 352041713180105/354704243180105. 352041713180113/354704243180113. 352041713180139/354704243180139. 352041713180154/35470
4243180154. 352041713180170/354704243180170.352041713180188/354704243180188. 352041713180261/354704243180261. 352041713180279/354
704243180279. 352041713180287/354704243180287. 352041713180311/354704243180311. 352041713180907/354704243180907. 352041713181012/
354704243181012. 352041713181053/354704243181053. 352041713181079/354704243181079. 352041713181137/354704243181137. 3520417131811
86/354704243181186. 352041713181285/354704243181285. 352041713181418/354704243181418. 352041713181467/354704243181467. 3520417131
81541/354704243181541. 352041713181566/354704243181566. 352041713181574/354704243181574.352041713181590/354704243181590. 35204171
3181616/354704243181616. 352041713181632/354704243181632. 352041713181665/354704243181665. 352041713181749/354704243181749. 35204
1713181756/354704243181756. 352041713181772/354704243181772. 352041713181830/354704243181830. 352041713181905/354704243181905. 35
2041713182200/354704243182200. 352041713182226/354704243182226. 352041713182275/354704243182275. 352041713182549/354704243182549.
352041713182556/354704243182556. 352041713182580/354704243182580. 352041713182622/354704243182622. 352041713182648/3547042431826
48. 352041713182655/354704243182655. 352041713182747/354704243182747. 352041713182754/354704243182754. 352041713182762/3547042431
82762. 352041713182887/354704243182887. 352041713182895/354704243182895. 352041713182903/354704243182903. 352041713182952/3547042
43182952. 352041713182978/354704243182978. 352041713182986/354704243182986. 352041713183034/354704243183034. 352041713183042/3547
04243183042. 352041713183091/354704243183091. 352041713183109/354704243183109. 352041713183117/354704243183117. 352041713183141/3
54704243183141. 352041713183166/354704243183166. 352041713183174/354704243183174. 352041713183182/354704243183182. 35204171318319
0/354704243183190. 352041713183216/354704243183216. 352041713183224/354704243183224. 352041713183232/354704243183232. 35204171318
3273/354704243183273. 352041713183299/354704243183299. 352041713183315/354704243183315. 352041713183323/354704243183323. 35204171
3183349/354704243183349. 352041713183356/354704243183356. 352041713183364/354704243183364. 352041713183422/354704243183422. 35204
1713183455/354704243183455. 352041713183463/354704243183463. 352041713183489/354704243183489. 352041713183505/354704243183505. 35
2041713183588/354704243183588.352041713183703/354704243183703. 352041713183711/354704243183711. 352041713183778/354704243183778.
352041713183802/354704243183802. 352041713183828/354704243183828. 352041713183844/354704243183844. 352041713183851/35470424318385
1. 352041713183901/354704243183901. 352041713183927/354704243183927. 352041713183976/354704243183976. 352041713183984/35470424318
3984. 352041713184008/354704243184008. 352041713184016/354704243184016. 352041713184099/354704243184099. 352041713184198/35470424
3184198. 352041713184206/354704243184206. 352041713184222/354704243184222.352041713184230/354704243184230. 352041713184248/354704
243184248. 352041713184289/354704243184289. 352041713184297/354704243184297. 352041713184313/354704243184313. 352041713184339/354
704243184339. 352041713184347/354704243184347. 352041713184354/354704243184354. 352041713184412/354704243184412. 352041713184461/
354704243184461. 352041713184487/354704243184487. 352041713184594/354704243184594. 352041713184610/354704243184610. 3520417131846
44/354704243184644. 352041713184669/354704243184669. 352041713184693/354704243184693. 352041713184719/354704243184719. 3520417131
84776/354704243184776. 352041713184842/354704243184842. 352041713184859/354704243184859. 352041713184917/354704243184917. 3520417
13184925/354704243184925. 352041713184941/354704243184941. 352041713185252/354704243185252. 352041713185534/354704243185534. 3520
41713185997/354704243185997. 352041713186151/354704243186151. 352041713186169/354704243186169. 352041713186458/354704243186458. 3
52041713186540/354704243186540. 352041713186565/354704243186565. 352041713186672/354704243186672. 352041713186698/354704243186698
. 352041713186730/354704243186730. 352041713186821/354704243186821. 352041713186847/354704243186847. 352041713186854/354704243186
854. 352041713186896/354704243186896. 352041713186912/354704243186912. 352041713186920/354704243186920. 352041713187050/354704243
187050. 352041713187373/354704243187373. 352041713187498/354704243187498. 352041713187589/354704243187589. 352041713187613/354704
243187613. 352041713187621/354704243187621. 352041713187688/354704243187688. 352041713187704/354704243187704. 352041713187746/354
704243187746. 352041713187811/354704243187811. 352041713187837/354704243187837. 352041713187902/354704243187902. 352041713187928/
354704243187928.352041713187944/354704243187944. 352041713187969/354704243187969. 352041713188405/354704243188405. 35204171318851
2/354704243188512. 352041713188603/354704243188603. 352041713188629/354704243188629. 352041713188678/354704243188678. 35204171318
8710/354704243188710. 352041713188728/354704243188728. 352041713188744/354704243188744. 352041713188785/354704243188785. 35204171
3188819/354704243188819. 352041713188868/354704243188868. 352041713188942/354704243188942. 352041713188967/354704243188967. 35204
1713188975/354704243188975. 352041713188991/354704243188991.352041713189064/354704243189064. 352041713189072/354704243189072. 352
041713189080/354704243189080. 352041713189098/354704243189098. 352041713189130/354704243189130. 352041713189221/354704243189221.
352041713189288/354704243189288. 352041713189304/354704243189304. 352041713189312/354704243189312. 352041713189320/35470424318932
0. 352041713189346/354704243189346. 352041713189353/354704243189353. 352041713189361/354704243189361. 352041713189379/35470424318
9379. 352041713189387/354704243189387. 352041713189395/354704243189395. 352041713189403/354704243189403. 352041713189411/35470424
3189411. 352041713189445/354704243189445. 352041713189452/354704243189452. 352041713189460/354704243189460. 352041713189478/35470
4243189478. 352041713189486/354704243189486. 352041713189494/354704243189494. 352041713189502/354704243189502. 352041713189536/35
4704243189536. 352041713189544/354704243189544. 352041713189569/354704243189569. 352041713189601/354704243189601. 352041713189627
/354704243189627. 352041713189650/354704243189650. 352041713189692/354704243189692. 352041713189908/354704243189908. 352041713189
965/354704243189965. 352041713190047/354704243190047. 352041713190138/354704243190138. 352041713190161/354704243190161. 352041713
190302/354704243190302. 352041713190344/354704243190344. 352041713190369/354704243190369. 352041713190385/354704243190385. 352041
713190393/354704243190393. 352041713190435/354704243190435. 352041713190450/354704243190450. 352041713190559/354704243190559. 352
041713190633/354704243190633. 352041713190674/354704243190674. 352041713190716/354704243190716. 352041713190807/354704243190807.
352041713190831/354704243190831. 352041713190849/354704243190849. 352041713190898/354704243190898. 352041713190906/35470424319090
6.352041713190914/354704243190914. 352041713190922/354704243190922. 352041713190930/354704243190930. 352041713190948/354704243190
948. 352041713190955/354704243190955. 352041713190963/354704243190963. 352041713191011/354704243191011. 352041713191078/354704243
191078. 352041713191086/354704243191086. 352041713191110/354704243191110. 352041713191151/354704243191151. 352041713191185/354704
243191185. 352041713191193/354704243191193. 352041713191375/354704243191375. 352041713191409/354704243191409. 352041713191466/354
704243191466. 352041713191524/354704243191524.352041713191532/354704243191532. 352041713191607/354704243191607. 352041713191615/3
54704243191615. 352041713191656/354704243191656. 352041713191714/354704243191714. 352041713191730/354704243191730. 35204171319176
3/354704243191763. 352041713191771/354704243191771. 352041713191797/354704243191797. 352041713191847/354704243191847. 35204171319
1896/354704243191896. 352041713191912/354704243191912. 352041713192019/354704243192019. 352041713192043/354704243192043. 35204171
3192118/354704243192118. 352041713192134/354704243192134. 352041713192142/354704243192142. 352041713192209/354704243192209. 35204
1713192225/354704243192225. 352041713192324/354704243192324. 352041713192340/354704243192340. 352041713192415/354704243192415. 35
2041713192423/354704243192423. 352041713192431/354704243192431. 352041713192449/354704243192449. 352041713192480/354704243192480.
352041713192498/354704243192498. 352041713192506/354704243192506. 352041713192514/354704243192514. 352041713192522/3547042431925
032025001881804-7
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001881804-7
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
22. 352041713192530/354704243192530. 352041713192548/354704243192548. 352041713192555/354704243192555. 352041713192563/3547042431
92563. 352041713192571/354704243192571. 352041713192589/354704243192589. 352041713192597/354704243192597. 352041713192621/3547042
43192621. 352041713192639/354704243192639. 352041713192654/354704243192654. 352041713192670/354704243192670. 352041713192688/3547
04243192688. 352041713192696/354704243192696. 352041713192753/354704243192753. 352041713192811/354704243192811. 352041713192852/3
54704243192852. 352041713192860/354704243192860. 352041713192928/354704243192928. 352041713192936/354704243192936. 35204171319294
4/354704243192944. 352041713192969/354704243192969. 352041713193017/354704243193017. 352041713193033/354704243193033.352041713193
041/354704243193041. 352041713193058/354704243193058. 352041713193066/354704243193066. 352041713193082/354704243193082. 352041713
193124/354704243193124. 352041713193132/354704243193132. 352041713193140/354704243193140. 352041713193157/354704243193157. 352041
713193165/354704243193165. 352041713193181/354704243193181. 352041713193199/354704243193199. 352041713193207/354704243193207. 352
041713193215/354704243193215. 352041713193223/354704243193223. 352041713193231/354704243193231. 352041713193256/354704243193256.
352041713193298/354704243193298.352041713193306/354704243193306. 352041713193314/354704243193314. 352041713193322/354704243193322
. 352041713193330/354704243193330. 352041713193355/354704243193355. 352041713193363/354704243193363. 352041713193371/354704243193
371. 352041713193389/354704243193389. 352041713193397/354704243193397. 352041713193405/354704243193405. 352041713193413/354704243
193413. 352041713193447/354704243193447. 352041713193454/354704243193454. 352041713193488/354704243193488. 352041713193504/354704
243193504. 352041713193512/354704243193512. 352041713193900/354704243193900. 352041713193918/354704243193918. 352041713193934/354
704243193934. 352041713193942/354704243193942. 352041713193959/354704243193959. 352041713193967/354704243193967. 352041713193975/
354704243193975. 352041713193991/354704243193991. 352041713194023/354704243194023. 352041713194064/354704243194064. 3520417131940
98/354704243194098. 352041713194130/354704243194130. 352041713194148/354704243194148. 352041713194189/354704243194189. 3520417131
94205/354704243194205. 352041713194221/354704243194221. 352041713194239/354704243194239. 352041713194262/354704243194262. 3520417
13194288/354704243194288. 352041713194296/354704243194296. 352041713194312/354704243194312. 352041713194320/354704243194320. 3520
41713194361/354704243194361. 352041713194379/354704243194379. 352041713194395/354704243194395. 352041713194403/354704243194403. 3
52041713194486/354704243194486. 352041713194494/354704243194494. 352041713194528/354704243194528. 352041713194585/354704243194585
. 352041713194692/354704243194692. 352041713194726/354704243194726. 352041713194734/354704243194734. 352041713194817/354704243194
817. 352041713194841/354704243194841. 352041713194858/354704243194858. 352041713194866/354704243194866.352041713194874/3547042431
94874. 352041713194882/354704243194882. 352041713194908/354704243194908. 352041713194916/354704243194916. 352041713194924/3547042
43194924. 352041713194932/354704243194932. 352041713194940/354704243194940. 352041713194957/354704243194957. 352041713194965/3547
04243194965. 352041713194973/354704243194973. 352041713194981/354704243194981. 352041713194999/354704243194999. 352041713195004/3
54704243195004. 352041713195020/354704243195020. 352041713195038/354704243195038. 352041713195046/354704243195046. 35204171319505
3/354704243195053.352041713195061/354704243195061. 352041713195079/354704243195079. 352041713195087/354704243195087. 352041713195
095/354704243195095. 352041713195103/354704243195103. 352041713195111/354704243195111. 352041713195129/354704243195129. 352041713
195137/354704243195137. 352041713195145/354704243195145. 352041713195152/354704243195152. 352041713195160/354704243195160. 352041
713195178/354704243195178. 352041713195186/354704243195186. 352041713195194/354704243195194. 352041713195202/354704243195202. 352
041713195210/354704243195210. 352041713195244/354704243195244. 352041713195251/354704243195251. 352041713195293/354704243195293.
352041713195319/354704243195319. 352041713195335/354704243195335. 352041713195343/354704243195343. 352041713195368/35470424319536
8. 352041713195384/354704243195384. 352041713195392/354704243195392. 352041713195400/354704243195400. 352041713195418/35470424319
5418. 352041713195426/354704243195426. 352041713195434/354704243195434. 352041713195442/354704243195442. 352041713195459/35470424
3195459. 352041713195467/354704243195467. 352041713195475/354704243195475. 352041713195491/354704243195491. 352041713195509/35470
4243195509. 352041713195517/354704243195517. 352041713195533/354704243195533. 352041713195558/354704243195558. 352041713195566/35
4704243195566. 352041713195582/354704243195582. 352041713195590/354704243195590. 352041713195608/354704243195608. 352041713195616
/354704243195616. 352041713195624/354704243195624. 352041713195632/354704243195632. 352041713195699/354704243195699. 352041713195
707/354704243195707. 352041713195814/354704243195814. 352041713216370/354704243216370. 352041713216446/354704243216446. 352041713
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032025001881804-7
Espacio para uso exclusivo de la Entidad Recaudadora
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