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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
032025001638102-5
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
Inicial
33 . Cod.
1
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. 116575016022917
43 . Año – Mes – Día
2025 – 09 – 09
44 . Documento de transporte
No. T61725H03139
45 . Año – Mes – Día
2025 – 09 – 06
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
6900387783
52 . Año – Mes – Día
2025 – 09 – 01
53 . Cod. país
procedencia
215
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.
3.991.09
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.
132.00
72 . Peso neto kgs. dcms.
90.65
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
370.00
78 .Valor FOB
USD
18.226.67
79 . Valor fletes USD
996.60 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
76.724.315
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
76.724.315
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
0.63
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
997.23
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
19.223.90
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: 572308-DECL: 1952972-DO: 893122440251- 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: 3097845970. ID DELIVERY: 6084379799. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A075MLVDLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A07 LTE DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VIOLETA(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
032025001638102
133. Feha: 202509 11
134 . Levante No. 032025001378369 135 . Fecha
2025 – 09 – 11
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 92032507072028
Fecha presentación 2025-09-11 10:01:07
Valor pagado $0.00
Fecha de Impresión: 2025-09-11 10:01:14
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001638102-5
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
, MODELO: SM-A075M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A075M/DS,LIGHT VIOLET,LTC( QTY. 370,00 u )(37
0,00 PCE); IMEIS: 352169181729648/354282521729646. 352169181729713/354282521729711. 352169181729754/354282521729752. 352169181729
762/354282521729760. 352169181729770/354282521729778. 352169181729804/354282521729802. 352169181729820/354282521729828. 352169181
729838/354282521729836. 352169181729846/354282521729844. 352169181729879/354282521729877. 352169181729887/354282521729885. 352169
181729895/354282521729893. 352169181729929/354282521729927.352169181729986/354282521729984. 352169181729994/354282521729992. 3521
69181730018/354282521730016. 352169181730059/354282521730057. 352169181730125/354282521730123. 352169181730166/354282521730164. 3
52169181730224/354282521730222. 352169181730265/354282521730263. 352169181730299/354282521730297. 352169181730315/354282521730313
. 352169181730356/354282521730354. 352169181730364/354282521730362. 352169181730505/3542825 21730503. 352169181730547/35428252173
0545. 352169181730687/354282521730685. 352169181730760/354282521730768. 352169181730869/354282521730867. 352169181731032/35428252
1731030. 352169181731057/354282521731055. 352169181731149/354282521731147. 352169181731230/354282521731238. 352169181731271/35428
2521731279. 352169181731297/354282521731295. 352169181731305/354282521731303. 352169181731313/354282521731311. 352169181731404/35
4282521731402. 352169181731412/354282521731410. 352169181731420/354282521731428. 352169181731438/354282521731436. 352169181731446
/354282521731444. 352169181731453/354282521731451. 352169181731461/354282521731469. 352169181731479/354282521731477. 352169181731
487/354282521731485. 352169181731511/354282521731519. 352169181731545/354282521731543. 352169181731594/354282521731592. 352169181
731610/354282521731618. 352169181731628/354282521731626. 352169181731636/354282521731634. 352169181731644/354282521731642. 352169
181731669/354282521731667. 352169181731677/354282521731675. 352169181731685/354282521731683. 352169181731727/354282521731725. 352
169181731735/354282521731733. 352169181731743/354282521731741. 352169181731750/354282521731758. 352169181731768/354282521731766.
352169181731776/354282521731774. 352169181731818/354282521731816. 352169181731867/354282521731865. 352169181731875/35428252173187
3.352169181731891/354282521731899. 352169181731909/354282521731907. 352169181731917/354282521731915. 352169181731925/354282521731
923. 352169181731941/354282521731949. 352169181731982/354282521731980. 352169181732014/354282521732012. 352169181732022/354282521
732020. 352169181732071/354282521732079. 352169181732089/354282521732087. 352169181732097/354282521732095. 352169181732105/354282
521732103. 352169181732113/354282521732111. 352169181732139/354282521732137. 352169181732154/354282521732152. 352169181732170/354
282521732178. 352169181732212/354282521732210.352169181732253/354282521732251. 352169181732295/354282521732293. 352169181732329/3
54282521732327. 352169181732337/354282521732335. 352169181732345/354282521732343. 352169181732352/354282521732350. 35216918173237
8/354282521732376. 352169181732436/354282521732434. 352169181732444/354282521732442. 352169181732451/354282521732459. 35216918173
2469/354282521732467. 352169181732477/354282521732475. 352169181732485/354282521732483. 352169181732493/354282521732491. 35216918
1732543/354282521732541. 352169181732568/354282521732566. 352169181732576/354282521732574. 352169181732584/354282521732582. 35216
9181732592/354282521732590. 352169181732600/354282521732608. 352169181732634/354282521732632. 352169181732667/354282521732665. 35
2169181732683/354282521732681. 352169181732717/354282521732715. 352169181732733/354282521732731. 352169181732741/354282521732749.
352169181732774/354282521732772. 352169181732782/354282521732780. 352169181732808/354282521732806. 352169181732816/3542825217328
14. 352169181732832/354282521732830. 352169181732840/354282521732848. 352169181732857/354282521732855. 352169181732865/3542825217
32863. 352169181732873/354282521732871. 352169181732881/354282521732889. 352169181732907/354282521732905. 352169181732915/3542825
21732913. 352169181732923/354282521732921. 352169181732931/354282521732939. 352169181732949/354282521732947. 352169181733046/3542
82521733044. 352169181733053/354282521733051. 352169181733095/354282521733093. 352169181733103/354282521733101. 352169181733137/3
54282521733135. 352169181733160/354282521733168. 352169181733178/354282521733176. 352169181733194/354282521733192. 35216918173320
2/354282521733200. 352169181733210/354282521733218. 352169181733244/354282521733242. 352169181733251/354282521733259.352169181733
319/354282521733317. 352169181733327/354282521733325. 352169181733335/354282521733333. 352169181733350/354282521733358. 352169181
733392/354282521733390. 352169181733400/354282521733408. 352169181733418/354282521733416. 352169181733426/354282521733424. 352169
181733434/354282521733432. 352169181733442/354282521733440. 352169181733467/354282521733465. 352169181733491/354282521733499. 352
169181733509/354282521733507. 352169181733525/354282521733523. 352169181733533/354282521733531. 352169181733541/354282521733549.
352169181733574/354282521733572.352169181733582/354282521733580. 352169181733608/354282521733606. 352169181733624/354282521733622
. 352169181733632/354282521733630. 352169181733640/354282521733648. 352169181733657/354282521733655. 352169181733665/354282521733
663. 352169181733673/354282521733671. 352169181733681/354282521733689. 352169181733699/354282521733697. 352169181733707/354282521
733705. 352169181733715/354282521733713. 352169181733731/354282521733739. 352169181733749/354282521733747. 352169181733756/354282
521733754. 352169181733764/354282521733762. 352169181733780/354282521733788. 352169181733806/354282521733804. 352169181733822/354
282521733820. 352169181733830/354282521733838. 352169181733855/354282521733853. 352169181733863/354282521733861. 352169181733889/
354282521733887. 352169181733913/354282521733911. 352169181733947/354282521733945. 352169181733970/354282521733978. 3521691817339
88/354282521733986. 352169181733996/354282521733994. 352169181734002/354282521734000. 352169181734010/354282521734018. 3521691817
34028/354282521734026. 352169181734044/354282521734042. 352169181734051/354282521734059. 352169181734069/354282521734067. 3521691
81734085/354282521734083. 352169181734093/354282521734091. 352169181734101/354282521734109. 352169181734168/354282521734166. 3521
69181734184/354282521734182. 352169181734192/354282521734190. 352169181734259/354282521734257. 352169181734267/354282521734265. 3
52169181734275/354282521734273. 352169181734291/354282521734299. 352169181734333/354282521734331. 352169181734366/354282521734364
. 352169181734374/354282521734372. 352169181734382/354282521734380. 352169181734390/354282521734398. 352169181734416/354282521734
414. 352169181734424/354282521734422. 352169181734440/354282521734448. 352169181734457/354282521734455.352169181734465/3542825217
34463. 352169181734507/354282521734505. 352169181734515/354282521734513. 352169181734523/354282521734521. 352169181734531/3542825
21734539. 352169181734549/354282521734547. 352169181734564/354282521734562. 352169181734572/354282521734570. 352169181734580/3542
82521734588. 352169181734630/354282521734638. 352169181734648/354282521734646. 352169181734663/354282521734661. 352169181734689/3
54282521734687. 352169181734705/354282521734703. 352169181734713/354282521734711. 352169181734721/354282521734729. 35216918173473
9/354282521734737.352169181734747/354282521734745. 352169181734754/354282521734752. 352169181734788/354282521734786. 352169181734
804/354282521734802. 352169181734838/354282521734836. 352169181734846/354282521734844. 352169181734853/354282521734851. 352169181
734861/354282521734869. 352169181734903/354282521734901. 352169181734929/354282521734927. 352169181734937/354282521734935. 352169
181734945/354282521734943. 352169181734960/354282521734968. 352169181734994/354282521734992. 352169181735017/354282521735015. 352
169181735041/354282521735049. 352169181735058/354282521735056. 352169181735066/354282521735064. 352169181735074/354282521735072.
352169181735090/354282521735098. 352169181735108/354282521735106. 352169181735116/354282521735114. 352169181735124/35428252173512
2. 352169181735132/354282521735130. 352169181735140/354282521735148. 352169181735157/354282521735155. 352169181735165/35428252173
5163. 352169181735173/354282521735171. 352169181735181/354282521735189. 352169181735249/354282521735247. 352169181735264/35428252
1735262. 352169181735306/354282521735304. 352169181735348/354282521735346. 352169181735355/354282521735353. 352169181735363/35428
2521735361. 352169181735371/354282521735379. 352169181735397/354282521735395. 352169181735405/354282521735403. 352169181735439/35
4282521735437. 352169181735447/354282521735445. 352169181735462/354282521735460. 352169181735470/354282521735478. 352169181735488
/354282521735486. 352169181735496/354282521735494. 352169181735504/354282521735502. 352169181735512/354282521735510. 352169181735
538/354282521735536. 352169181735561/354282521735569. 352169181735579/354282521735577. 352169181735611/354282521735619. 352169181
735637/354282521735635. 352169181735652/354282521735650. 352169181735728/354282521735726.352169181735751/354282521735759. 3521691
81735785/354282521735783. 352169181735793/354282521735791. 352169181735801/354282521735809. 352169181735819/354282521735817. 3521
69181735827/354282521735825. 352169181735835/354282521735833. 352169181735843/354282521735841. 352169181735850/354282521735858. 3
52169181735876/354282521735874. 352169181735884/354282521735882. 352169181735892/354282521735890. 352169181735900/354282521735908
032025001638102-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001638102-5
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
. 352169181735918/354282521735916. 352169181735942/354282521735940. 352169181735959/354282521735957. 352169181735967/354282521735
965.352169181735975/354282521735973. 352169181735983/354282521735981. 352169181735991/354282521735999. 352169181736007/3542825217
36005. 352169181736015/354282521736013. 352169181736023/354282521736021. 352169181736031/354282521736039. 352169181736049/3542825
21736047. 352169181736080/354282521736088. 352169181736098/354282521736096. 352169181736106/354282521736104. 352169181736114/3542
82521736112. 352169181736122/354282521736120. 352169181736130/354282521736138. 352169181736148/354282521736146. 352169181736155/3
54282521736153. 352169181736163/354282521736161. 352169181736171/354282521736179. 352169181736189/354282521736187. 35216918173619
7/354282521736195. 352169181736205/354282521736203. 352169181736221/354282521736229. 352169181736239/354282521736237. 35216918173
6247/354282521736245. 352169181736262/354282521736260. 352169181736270/354282521736278. 352169181736288/354282521736286. 35216918
1736296/354282521736294. 352169181736304/354282521736302. 352169181736312/354282521736310. 352169181736320/354282521736328. 35216
9181736338/354282521736336. 352169181736346/354282521736344. 352169181736353/354282521736351. 352169181736361/354282521736369. 35
2169181736379/354282521736377. 352169181736387/354282521736385. 352169181736395/354282521736393. 352169181736411/354282521736419.
352169181736437/354282521736435. 352169181736445/354282521736443. 352169181736460/354282521736468. 352169181736478/3542825217364
76. 352169181736486/354282521736484. 352169181736494/354282521736492. 352169181736502/354282521736500. 352169181736510/3542825217
36518. 352169181736551/354282521736559. 352169181736569/354282521736567. 352169181736577/354282521736575. 352169181736585/3542825
21736583. 352169181736593/354282521736591. 352169181736601/354282521736609.352169181736619/354282521736617. 352169181736635/35428
2521736633. 352169181736668/354282521736666. 352169181736676/354282521736674. 352169181736684/354282521736682. 352169181736692/35
4282521736690. 352169181736700/354282521736708. 352169181736726/354282521736724. 352169181736742/354282521736740. 352169181736759
/354282521736757. 352169181736775/354282521736773. 352169181736783/354282521736781. 352169181736791/354282521736799. 352169181736
825/354282521736823. 352169181736833/354282521736831. 352169181736858/354282521736856. 352169181736866/354282521736864.3521691817
36874/354282521736872. 352169181736882/354282521736880. 352169181736890/354282521736898. 352169181736940/354282521736948. 3521691
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032025001638102-5
Espacio para uso exclusivo de la Entidad Recaudadora
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