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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
032025002096585-5
5 . Número de Identificación Tributaria (NIT)
800091549
6 . DV.
2
11 . Apellidos y nombres o Razón Social
IMPRESISTEM S A S
13 . Dirección
AUT MEDELLIN CL 80 KM 2
15 . Teléfono
8766500
12 . Cód. Admón.
03
16 . Cód. Dpto
25
17 . Cód. Ciudad Municipio
214
24 . Número de Identificación Tributaria (NIT)
830122083
25 . DV.
6
26 . Razón social del declarante autorizado
AGENCIA DE ADUANAS LATINOAMERICANA DE ADUANAS SAS NIVEL 2
27 . Tipo usuario
26
28 . Cód. usuario
459
29 . Número documento de identificación
1023862658
30 . Apellidos y nombres
GONZALEZ ACERO KELLY JOHANNA
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
26924
42 . Manifiesto de carga
No. 116575016335960
43 . Año – Mes – Día
2025 – 11 – 25
44 . Documento de transporte
No. HKG0467494
45 . Año – Mes – Día
2025 – 11 – 20
46 . Nombre exportador o proveedor en el exterior
IMC INTERNATIONAL INC
47 . Ciudad
MIAMI
48 . Cod.País Exportador
249
49 . Dirección exportador o proveedor en el exterior
7707 NW 46 STREET MIAMI, FL 33166
50 . E-mail
3059947965
51 . No. de factura
24006
52 . Año – Mes – Día
2025 – 11 – 20
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
169
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
3.773.60
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
03
69 . Tipo de
importación
01
70 . Cod. país
compra
249
71 . Peso bruto kgs. dcms.
831.50
72 . Peso neto kgs. dcms.
748.35
73 . Código
embalaje
PK
74 . No. bultos
4
75 . Subpartidas
1
76 . Cod. unidad
comercialU
77 . Cantidad dcms.
1.500.00
78 .Valor FOB USD 79 . Valor fletes USD
Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($)
Total Liquidado
(USD)
Arancel 92
0.00
93 94
0
95
0
96
0.00
I.V.A. 97
0.00
98 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 81 . Valor Otros Gastos USD
0
82 . Sumatoria de fletes, seguros
y otros gastos USD
83 . Ajuste valor USD
0.00
84 . Valor aduana USD 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)
DO 202536089 CODIGO / RESOLUCION OEA IMPORTADOR: OE0169; DECLARACION(1-2) NOS ACOGEMOS AL ART 424 DEL ESTATUTO TRIBUTARIO MODIFIC
ADO POR LEY 1819 DE 29 DE DICIEMBRE 2016, NUEVA REFORMA TRIBUTARIA, ART 175 PARA COMPUTADORES PORTATILES, DE ESCRITORIO TABLETAS
Y CELULARES// HOMOLOGACION DE EQUIPO MARCA REDMI MODELO: 25078RA3EL, RADICACION: 2025519080, FECHA: 2025-06-20 // DOCUMENTO DE VE
RIFICACION DE IMEI: DV-246886, FECHA: 2025-11-21. //. FACTURA: 24006 FECHA: 2025-11-20 NOS ACOGEMOS AL DECRETO 1881 DEL 2021, NOS
ACOGEMOS AL DECRETO 0925 DE MAYO 9 DEL 2013, MINISTERIO DE COMERCIO EXTERIOR, IMPORTACIÓN EXENTA DE REGISTRO DE IMPORTACIÓN.. CA
NT (1500) UND TELEFONO CELULAR, 1066961 Redmi 15C Midnight Black 4GB RAM 256GB ROM // ESPECIFICACIONES: PRO(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
032025002096585
133. Feha: 2025 12 02
134 . Levante No. 032025001803098 135 . Fecha
2025 – 12 – 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 92032509535183
Fecha presentación 2025-12-02 14:28:39
Valor pagado $0.00
Fecha de Impresión: 2025-12-02 14:32:16
IMP
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025002096585-5
Subpartida : 8517130000
Página 1 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
CESADOR: OCTA-CORE, PANTALLA/DISPLAY: 6.9 PULGADAS (17.53 CM), MEMORIA: 4 GB, CAPACIDAD: 256 GB, SISTEMA OPERATIVO: ANDROID 15, H
YPEROS 2// EAN: 6932554444815 TELEFONO CELULAR REDMI 15 C NEGRO OCASO 4 GB RAM 256 GB ROM, ALIMENTACION: 5V = 3A/3.,6-11V = 3A 33
W MAX 50 MP SL DUAL CAMERA SYSTEM, BATTERY 6000 MAH (TIP) CARGA RAPIDA DE 33 W, TASA DE ACTUALIZACION DE 120 HZ, PANTALLA DE 6.9
(17.53 CM) 4+4GB CON EXTENSION 8 GB RAM 256 GB ROM EN LA CAJA: TELEFONO CELULAR, ADAPTADOR DE CORRIENTE, CABLE USB, TIPO-C, LLAVE
PARA SIM CARD, CARCASA PROTECTORA, GUIA DE INCIORAPIDO, Y TARJETA DE GARANTIA, PRODUCT TERMOSELLADO COD.:1066961; PRODUCTO: TELE
FONO CELULAR, MARCA: REDMI/MI, MODELO: 25078RA3EL, REFERENCIA: 67515/MZB0KO5US, USO ODESTINO: COMUNICACIÓN, PARA ALMACENAMIENTO Y
PROCESAMIENTO DE DATOS, SERIAL// IMEI NO. (CODIGO DE QUINCE -15- DIGITOS): 67515/65XD03938//863914089644080//863914089644098, 67
515/65XD03944//863914089644205//863914089644213, 67515/65XD03946//863914089644247//863914089644254, 67515/65XD00181//863914089644
627//863914089644635, 67515/65XD00183//863914089644668//863914089644676, 67515/65XD00198//863914089644965//863914089644973, 67515
/65XD00247//863914089645103//863914089645111, 67515/65XD00541//863914089645384//863914089645392, 67515/65XD00542//863914089645400
//863914089645418, 67515/65XD00544//863914089645442//863914089645459, 67515/65XD00560//863914089645764//863914089645772, 67515/65
XD00574//863914089646044//863914089646051, 67515/65XD02829//863914089646382//863914089646390, 67515/65XD02830//863914089646408//8
63914089646416, 67515/65XD02848//863914089646762//863914089646770, 67515/65XD02873//863914089647083//863914089647091, 67515/65XD0
2874//863914089647109//863914089647117, 67515/65XD02892//863914089647463//863914089647471, 67515/65XD03060//863914089647620//8639
14089647638, 67515/65XD00021//863914089649022//863914089649030, 67515/65XD00023//863914089649063//863914089649071, 67515/65XD0002
4//863914089649089//863914089649097, 67515/65XD00025//863914089649105//863914089649113, 67515/65XD00030//863914089649204//8639140
89649212, 67515/65XD00032//863914089649246//863914089649253, 67515/65XD00033//863914089649261//863914089649279, 67515/65XD00034//
863914089649287//863914089649295, 67515/65XD00038//863914089649360//863914089649378, 67515/65XD00039//863914089649386//8639140896
49394, 67515/65XD00040//863914089649402//863914089649410, 67515/65XD00041//863914089649428//863914089649436, 67515/65XD00042//863
914089649444//863914089649451, 67515/65XD00043//863914089649469//863914089649477, 67515/65XD00044//863914089649485//8639140896494
93, 67515/65XD00045//863914089649501//863914089649519, 67515/65XD00047//863914089649543//863914089649550, 67515/65XD00048//863914
089649568//863914089649576, 67515/65XD00049//863914089649584//863914089649592, 67515/65XD00050//863914089649600//863914089649618,
67515/65XD00051//863914089649626//863914089649634, 67515/65XD00054//863914089649683//863914089649691, 67515/65XD00056//863914089
649725//863914089649733, 67515/65XD00058//863914089649766//863914089649774, 67515/65XD00059//863914089649782//863914089649790, 67
515/65XD00060//863914089649808//863914089649816, 67515/65XD00341//863914089649824//863914089649832, 67515/65XD00342//863914089649
840//863914089649857, 67515/65XD00343//863914089649865//863914089649873, 67515/65XD00344//863914089649881//863914089649899, 67515
/65XD00346//863914089649923//863914089649931, 67515/65XD00347//863914089649949//863914089649956, 67515/65XD01327//863914089650145
//863914089650152, 67515/65XD01428//863914089650566//863914089650574, 67515/65XD01449//863914089650988//863914089650996, 67515/65
XD00381//863914089651044//863914089651051, 67515/65XD00385//863914089651127//863914089651135, 67515/65XD00388//863914089651184//8
63914089651192, 67515/65XD00390//863914089651226//863914089651234, 67515/65XD00395//863914089651325//863914089651333, 67515/65XD0
0396//863914089651341//863914089651358, 67515/65XD00404//863914089651507//863914089651515, 67515/65XD00409//863914089651606//8639
14089651614, 67515/65XD00417//863914089651762//863914089651770, 67515/65XD00419//863914089651804//863914089651812, 67515/65XD0042
0//863914089651820//863914089651838, 67515/65XD00741//863914089651846//863914089651853, 67515/65XD01757//863914089652729//8639140
89652737, 67515/65XD01758//863914089652745//863914089652752, 67515/65XD01763//863914089652844//863914089652851, 67515/65XD01776//
863914089653107//863914089653115, 67515/65XD01777//863914089653123//863914089653131, 67515/65XD01820//863914089653149//8639140896
53156, 67515/65XD01675//863914089653446//863914089653453, 67515/65XD01679//863914089653529//863914089653537, 67515/65XD01680//863
914089653545//863914089653552, 67515/65XD01688//863914089653701//863914089653719, 67515/65XD01689//863914089653727//8639140896537
35, 67515/65XD01690//863914089653743//863914089653750, 67515/65XD01691//863914089653768//863914089653776, 67515/65XD01692//863914
089653784//863914089653792, 67515/65XD01693//863914089653800//863914089653818, 67515/65XD01695//863914089653842//863914089653859,
67515/65XD01829//863914089654121//863914089654139, 67515/65XD02129//863914089654261//863914089654279, 67515/65XD02130//863914089
654287//863914089654295, 67515/65XD02316//863914089654881//863914089654899, 67515/65XD01985//863914089655862//863914089655870, 67
515/65XD02768//863914089656167//863914089656175, 67515/65XD02769//863914089656183//863914089656191, 67515/65XD02770//863914089656
209//863914089656217, 67515/65XD02936//863914089656324//863914089656332, 67515/65XD02943//863914089656464//863914089656472, 67515
/65XD02969//863914089656985//863914089656993, 67515/65XD03786//863914089657223//863914089657231, 67515/65XD03787//863914089657249
//863914089657256, 67515/65XD03788//863914089657264//863914089657272, 67515/65XD03789//863914089657280//863914089657298, 67515/65
XD03790//863914089657306//863914089657314, 67515/65XD03791//863914089657322//863914089657330, 67515/65XD03794//863914089657389//8
63914089657397, 67515/65XD03796//863914089657421//863914089657439, 67515/65XD03797//863914089657447//863914089657454, 67515/65XD0
3798//863914089657462//863914089657470, 67515/65XD03800//863914089657504//863914089657512, 67515/65XD03803//863914089657561//8639
14089657579, 67515/65XD03804//863914089657587//863914089657595, 67515/65XD00106//863914089657702//863914089657710, 67515/65XD0010
8//863914089657744//863914089657751, 67515/65XD00111//863914089657801//863914089657819, 67515/65XD00112//863914089657827//8639140
89657835, 67515/65XD00113//863914089657843//863914089657850, 67515/65XD00114//863914089657868//863914089657876, 67515/65XD00116//
863914089657900//863914089657918, 67515/65XD00121//863914089658007//863914089658015, 67515/65XD00123//863914089658049//8639140896
58056, 67515/65XD03012//863914089658247//863914089658254, 67515/65XD03170//863914089658288//863914089658296, 67515/65XD03171//863
914089658304//863914089658312, 67515/65XD03172//863914089658320//863914089658338, 67515/65XD03176//863914089658403//8639140896584
11, 67515/65XD03178//863914089658445//863914089658452, 67515/65XD03179//863914089658460//863914089658478, 67515/65XD03180//863914
089658486//863914089658494, 67515/65XD03185//863914089658585//863914089658593, 67515/65XD03187//863914089658627//863914089658635,
67515/65XD03195//863914089658783//863914089658791, 67515/65XD03903//863914089659468//863914089659476, 67515/65XD00206//863914089
660169//863914089660177, 67515/65XD00508//863914089660607//863914089660615, 67515/65XD00518//863914089660805//863914089660813, 67
515/65XD00533//863914089661100//863914089661118, 67515/65XD00902//863914089661209//863914089661217, 67515/65XD00917//863914089661
506//863914089661514, 67515/65XD00921//863914089661589//863914089661597, 67515/65XD00922//863914089661605//863914089661613, 67515
/65XD00935//863914089661860//863914089661878, 67515/65XD00939//863914089661944//863914089661951, 67515/65XD02218//863914089661985
//863914089661993, 67515/65XD02219//863914089662009//863914089662017, 67515/65XD03027//863914089662223//863914089662231, 67515/65
XD03036//863914089662405//863914089662413, 67515/65XD03038//863914089662447//863914089662454, 67515/65XD03039//863914089662462//8
63914089662470, 67515/65XD03045//863914089662587//863914089662595, 67515/65XD00267//863914089662884//863914089662892, 67515/65XD0
0270//863914089662942//863914089662959, 67515/65XD00271//863914089662967//863914089662975, 67515/65XD00274//863914089663023//8639
14089663031, 67515/65XD00275//863914089663049//863914089663056, 67515/65XD00276//863914089663064//863914089663072, 67515/65XD0027
8//863914089663106//863914089663114, 67515/65XD00283//863914089663205//863914089663213, 67515/65XD03084//863914089663221//8639140
89663239, 67515/65XD03223//863914089663684//863914089663692, 67515/65XD03246//863914089664146//863914089664153, 67515/65XD03281//
863914089665143//863914089665150, 67515/65XD00350//863914089665382//863914089665390, 67515/65XD00351//863914089665408//8639140896
65416, 67515/65XD00353//863914089665440//863914089665457, 67515/65XD00355//863914089665481//863914089665499, 67515/65XD00359//863
914089665564//863914089665572, 67515/65XD00360//863914089665580//863914089665598, 67515/65XD00363//863914089665648//8639140896656
55, 67515/65XD00364//863914089665663//863914089665671, 67515/65XD00366//863914089665705//863914089665713, 67515/65XD00375//863914
089665887//863914089665895, 67515/65XD00380//863914089665986//863914089665994, 67515/65XD00701//863914089666000//863914089666018,
67515/65XD00706//863914089666109//863914089666117, 67515/65XD01460//863914089666588//863914089666596, 67515/65XD01579//863914089
667362//863914089667370, 67515/65XD00768//863914089667685//863914089667693, 67515/65XD01142//863914089667966//863914089667974, 67
032025002096585-5
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025002096585-5
Subpartida : 8517130000
Página 2 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
515/65XD01143//863914089667982//863914089667990, 67515/65XD01149//863914089668105//863914089668113, 67515/65XD01159//863914089668
303//863914089668311, 67515/65XD01780//863914089668485//863914089668493, 67515/65XD01279//863914089668881//863914089668899, 67515
/65XD01842//863914089669723//863914089669731, 67515/65XD01843//863914089669749//863914089669756, 67515/65XD01845//863914089669780
//863914089669798, 67515/65XD01850//863914089669889//863914089669897, 67515/65XD01852//863914089669921//863914089669939, 67515/65
XD01859//863914089670069//863914089670077, 67515/65XD01899//863914089670127//863914089670135, 67515/65XD01900//863914089670143//8
63914089670150, 67515/65XD01901//863914089670168//863914089670176, 67515/65XD01902//863914089670184//863914089670192, 67515/65XD0
1903//863914089670200//863914089670218, 67515/65XD01905//863914089670242//863914089670259, 67515/65XD01911//863914089670366//8639
14089670374, 67515/65XD01913//863914089670408//863914089670416, 67515/65XD01915//863914089670440//863914089670457, 67515/65XD0191
7//863914089670481//863914089670499, 67515/65XD01920//863914089670549//863914089670556, 67515/65XD02323//863914089670580//8639140
89670598, 67515/65XD02332//863914089670762//863914089670770, 67515/65XD02421//863914089670945//863914089670952, 67515/65XD02423//
863914089670986//863914089670994, 67515/65XD02429//863914089671109//863914089671117, 67515/65XD02433//863914089671182//8639140896
71190, 67515/65XD01995//863914089671620//863914089671638, 67515/65XD02147//863914089672263//863914089672271, 67515/65XD03147//863
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032025002096585-5
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
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Aceptación : 032025002096585-5
Subpartida : 8517130000
Página 3 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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Página 5 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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Página 6 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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Página 7 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
686//863914089803694, 67515/65XD09589//863914089803702//863914089803710, 67515/65XD09592//863914089803769//863914089803777, 67515
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032025002096585-5
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025002096585-5
Subpartida : 8517130000
Página 8 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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5//863914089868762//863914089868770, 67515/65XD10260//863914089868861//863914089868879, 67515/65XD10196//863914089872889//8639140
89872897, 67515/65XD07068//863914089877243//863914089877250, 67515/65XD07212//863914089878167//863914089878175, 67515/65XD09888//
863914089879207//863914089879215, 67515/65XD09902//863914089879488//863914089879496, 67515/65XD09915//863914089879744//8639140898
79751, 67515/65XD09919//863914089879827//863914089879835, 67515/65XD07910//863914089881161//863914089881179, 67515/65XD07927//863
914089881500//863914089881518, 67515/65XD08395//863914089883043//863914089883050, 67515/65XD08396//863914089883068//8639140898830
76, 67515/65XD09249//863914089883381//863914089883399, 67515/65XD09256//863914089883522//863914089883530, 67515/65XD09260//863914
089883605//863914089883613, 67515/65XD09275//863914089883902//863914089883910, PAIS ORIGEN: CHINA – 215. //XXXXXXXXXXXXXXXXXXXXXX
032025002096585-5
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Aceptación : 032025002096585-5
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Página 9 de 9
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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032025002096585-5
Espacio para uso exclusivo de la Entidad Recaudadora
