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VER MAS
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
032025001847819-3
5 . Número de Identificación Tributaria (NIT)
830028931
6 . DV.
5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
13 . Dirección
CR 7 113 43 OF 607
15 . Teléfono
4870707
12 . Cód. Admón.
03
16 . Cód. Dpto
11
17 . Cód. Ciudad Municipio
001
24 . Número de Identificación Tributaria (NIT)
860536003
25 . DV.
3
26 . Razón social del declarante autorizado
AGENCIA DE ADUANAS ABC REPECEV S.A.S. NIVEL 1
27 . Tipo usuario
26
28 . Cód. usuario
99
29 . Número documento de identificación
1022943854
30 . Apellidos y nombres
CARLOS ANDRES ROJAS MATAJUDIOS
31 . Clase
Importador
02
32 . Tipo declaración
Anticipada
33 . Cod.
3
34 .No.Formulario Anterior
XXXXXXXXXXXXXX
35 . Año – Mes – Día
XXXX – XX – XX
36 . Cod. Admón.
XX
37 . Declaración de Exportación
No. XXXXXXXXXXXXXXX
38 . Año – Mes – Día
XXXX – XX – XX
39 . Cod. Admón.
XX
40 . Cod. lugar ingreso
de las mercancías
BOG
41 . Cod. Depósito
99900
42 . Manifiesto de carga
No. 116575016199782
43 . Año – Mes – Día
2025 – 10 – 23
44 . Documento de transporte
No. SHAN0433029
45 . Año – Mes – Día
2025 – 10 – 16
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
9103860103
52 . Año – Mes – Día
2025 – 10 – 16
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.
106.50
72 . Peso neto kgs. dcms.
84.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
300.00
78 .Valor FOB
USD
56.502.48
79 . Valor fletes USD
914.84 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
222.618.297
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
222.618.297
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
1.89
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
916.73
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
57.419.21
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: 577428-DECL: 1965127-DO: 893125957251- 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: 3101215662. ID DELIVERY: 6085105379. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A366EZKGLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A36 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, M(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
032025001847819
133. Feha: 202510 20
134 . Levante No. 032025001598512 135 . Fecha
2025 – 10 – 24
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 92032508201735
Fecha presentación 2025-10-20 14:45:57
Valor pagado $0.00
Fecha de Impresión: 2025-10-24 10:08:02
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001847819-3
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A366E/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A366E/DS,BLACK,LTC( QTY. 300,00 u )(300,00 PCE )
; IMEIS: 352041713052510/354704243052510. 352041713052544/354704243052544. 352041713052569/354704243052569. 352041713068482/35470
4243068482. 352041713068508/354704243068508. 352041713068532/354704243068532. 352041713068557/354704243068557. 352041713068573/35
4704243068573. 352041713068607/354704243068607.352041713068623/354704243068623. 352041713068649/354704243068649. 352041713068656/
354704243068656. 352041713068664/354704243068664. 352041713068672/354704243068672. 352041713068680/354704243068680. 3520417130686
98/354704243068698. 352041713068714/354704243068714. 352041713068730/354704243068730. 352041713068748/354704243068748. 3520417130
68755/354704243068755. 352041713068763/354704243068763. 352041713068797/354704243068797. 352041713068805/354704243068805. 3520417
13068847/354704243068847. 352041713068870/354704243068870. 352041713068938/354704243068938. 352041713069019/354704243069019. 3520
41713069035/354704243069035. 352041713069050/354704243069050. 352041713069068/354704243069068. 352041713069084/354704243069084. 3
52041713069092/354704243069092. 352041713069100/354704243069100. 352041713069118/354704243069118. 352041713069134/354704243069134
. 352041713069159/354704243069159. 352041713069183/354704243069183. 352041713069217/354704243069217. 352041713069241/354704243069
241. 352041713069258/354704243069258. 352041713069308/354704243069308. 352041713069357/354704243069357. 352041713069373/354704243
069373. 352041713069407/354704243069407. 352041713069415/354704243069415. 352041713069423/354704243069423. 352041713069431/354704
243069431. 352041713069464/354704243069464. 352041713069506/354704243069506. 352041713069514/354704243069514. 352041713069522/354
704243069522. 352041713069555/354704243069555. 352041713069670/354704243069670. 352041713069720/354704243069720. 352041713069761/
354704243069761. 352041713069779/354704243069779. 352041713069845/354704243069845. 352041713069902/354704243069902. 3520417130699
10/354704243069910. 352041713069951/354704243069951. 352041713069977/354704243069977. 352041713069993/354704243069993. 3520417130
70025/354704243070025. 352041713070033/354704243070033. 352041713070041/354704243070041. 352041713070058/354704243070058. 3520417
13070066/354704243070066. 352041713070074/354704243070074. 352041713070116/354704243070116. 352041713070132/354704243070132. 3520
41713070165/354704243070165. 352041713070173/354704243070173. 352041713070181/354704243070181. 352041713070199/354704243070199. 3
52041713070207/354704243070207. 352041713070215/354704243070215. 352041713070223/354704243070223. 352041713070249/354704243070249
. 352041713070256/354704243070256.352041713070264/354704243070264. 352041713070272/354704243070272. 352041713070298/3547042430702
98. 352041713070355/354704243070355. 352041713070439/354704243070439. 352041713070454/354704243070454. 352041713070470/3547042430
70470. 352041713070488/354704243070488. 352041713070496/354704243070496. 352041713070504/354704243070504. 352041713070512/3547042
43070512. 352041713070520/354704243070520. 352041713070538/354704243070538. 352041713070546/354704243070546. 352041713070561/3547
04243070561. 352041713070579/354704243070579. 352041713070587/354704243070587.352041713070595/354704243070595. 352041713070603/35
4704243070603. 352041713070611/354704243070611. 352041713070629/354704243070629. 352041713070637/354704243070637. 352041713070645
/354704243070645. 352041713070652/354704243070652. 352041713070710/354704243070710. 352041713070736/354704243070736. 352041713070
744/354704243070744. 352041713070751/354704243070751. 352041713070769/354704243070769. 352041713070793/354704243070793. 352041713
070819/354704243070819. 352041713070835/354704243070835. 352041713070850/354704243070850. 352041713070959/354704243070959. 352041
713070967/354704243070967. 352041713070975/354704243070975. 352041713071023/354704243071023. 352041713071072/354704243071072. 352
041713071155/354704243071155. 352041713071163/354704243071163. 352041713071221/354704243071221. 352041713071239/354704243071239.
352041713071247/354704243071247. 352041713071254/354704243071254. 352041713071270/354704243071270. 352041713071312/35470424307131
2. 352041713071320/354704243071320. 352041713071346/354704243071346. 352041713071361/354704243071361. 352041713071411/35470424307
1411. 352041713071528/354704243071528. 352041713071593/354704243071593. 352041713071601/354704243071601. 352041713071619/35470424
3071619. 352041713071627/354704243071627. 352041713071635/354704243071635. 352041713071684/354704243071684. 352041713071718/35470
4243071718. 352041713071742/354704243071742. 352041713071809/354704243071809. 352041713071866/354704243071866. 352041713071882/35
4704243071882. 352041713071908/354704243071908. 352041713071924/354704243071924. 352041713071940/354704243071940. 352041713071981
/354704243071981. 352041713072021/354704243072021. 352041713072039/354704243072039. 352041713072070/354704243072070. 352041713072
088/354704243072088.352041713072112/354704243072112. 352041713072138/354704243072138. 352041713072146/354704243072146. 3520417130
72161/354704243072161. 352041713072245/354704243072245. 352041713072252/354704243072252. 352041713072260/354704243072260. 3520417
13072278/354704243072278. 352041713072302/354704243072302. 352041713072310/354704243072310. 352041713072328/354704243072328. 3520
41713072369/354704243072369. 352041713072385/354704243072385. 352041713072393/354704243072393. 352041713072419/354704243072419. 3
52041713072435/354704243072435. 352041713072443/354704243072443.352041713072468/354704243072468. 352041713072518/354704243072518.
352041713072542/354704243072542. 352041713072609/354704243072609. 352041713072641/354704243072641. 352041713072690/3547042430726
90. 352041713072708/354704243072708. 352041713072716/354704243072716. 352041713072732/354704243072732. 352041713072740/3547042430
72740. 352041713072781/354704243072781. 352041713072799/354704243072799. 352041713072872/354704243072872. 352041713072930/3547042
43072930. 352041713072963/354704243072963. 352041713072997/354704243072997. 352041713073003/354704243073003. 352041713073037/3547
04243073037. 352041713073094/354704243073094. 352041713073102/354704243073102. 352041713073136/354704243073136. 352041713073151/3
54704243073151. 352041713073169/354704243073169. 352041713073193/354704243073193. 352041713073227/354704243073227. 35204171307325
0/354704243073250. 352041713073268/354704243073268. 352041713073342/354704243073342. 352041713073441/354704243073441. 35204171307
3458/354704243073458. 352041713073466/354704243073466. 352041713073482/354704243073482. 352041713073490/354704243073490. 35204171
3073508/354704243073508. 352041713073516/354704243073516. 352041713073524/354704243073524. 352041713073532/354704243073532. 35204
1713073557/354704243073557. 352041713073565/354704243073565. 352041713073573/354704243073573. 352041713073607/354704243073607. 35
2041713073615/354704243073615. 352041713073623/354704243073623. 352041713073631/354704243073631. 352041713073656/354704243073656.
352041713073664/354704243073664. 352041713073672/354704243073672. 352041713073680/354704243073680. 352041713073706/3547042430737
06. 352041713073755/354704243073755. 352041713073789/354704243073789. 352041713073797/354704243073797. 352041713073805/3547042430
73805.352041713073813/354704243073813. 352041713073847/354704243073847. 352041713073896/354704243073896. 352041713073912/35470424
3073912. 352041713073946/354704243073946. 352041713073979/354704243073979. 352041713073987/354704243073987. 352041713073995/35470
4243073995. 352041713074019/354704243074019. 352041713074050/354704243074050. 352041713074092/354704243074092. 352041713074100/35
4704243074100. 352041713074225/354704243074225. 352041713074233/354704243074233. 352041713074241/354704243074241. 352041713074290
/354704243074290. 352041713074308/354704243074308.352041713074332/354704243074332. 352041713074340/354704243074340. 3520417130743
57/354704243074357. 352041713074399/354704243074399. 352041713074415/354704243074415. 352041713074431/354704243074431. 3520417130
74464/354704243074464. 352041713074480/354704243074480. 352041713074506/354704243074506. 352041713074514/354704243074514. 3520417
13074522/354704243074522. 352041713074530/354704243074530. 352041713074563/354704243074563. 352041713074571/354704243074571. 3520
41713074589/354704243074589. 352041713074639/354704243074639. 352041713074654/354704243074654. 352041713074688/354704243074688. 3
52041713074696/354704243074696. 352041713074704/354704243074704. 352041713074746/354704243074746. 352041713074761/354704243074761
. 352041713074779/354704243074779. 352041713074795/354704243074795. 352041713074829/354704243074829. 352041713074837/354704243074
837. 352041713074845/354704243074845. 352041713074852/354704243074852. 352041713074860/354704243074860. 352041713074886/354704243
074886. 352041713074894/354704243074894. 352041713074902/354704243074902. 352041713074928/354704243074928. 352041713074936/354704
243074936. 352041713074944/354704243074944. 352041713074951/354704243074951. 352041713074977/354704243074977. 352041713074985/354
704243074985. 352041713074993/354704243074993. 352041713075024/354704243075024. 352041713075032/354704243075032. 352041713075057/
354704243075057. 352041713075073/354704243075073. 352041713075115/354704243075115. 352041713075131/354704243075131. 3520417130751
49/354704243075149. 352041713075164/354704243075164. 352041713075214/354704243075214. 352041713075255/354704243075255. 3520417130
75263/354704243075263. 352041713075305/354704243075305. 352041713075339/354704243075339. 352041713075370/354704243075370.35204171
032025001847819-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001847819-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
3075412/354704243075412. 352041713075511/354704243075511. 352041713075578/354704243075578. 352041713075628/354704243075628. 35204
1713075636/354704243075636. 352041713075669/354704243075669. 352041713075677/354704243075677. 352041713075701/354704243075701. 35
2041713075719/354704243075719. 352041713075727/354704243075727. 352041713075735/354704243075735XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025001847819-3
Espacio para uso exclusivo de la Entidad Recaudadora
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