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REPÚBLICA DE COLOMBIA
Declaración de Importación Privada 500
1. Año 2026
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032026000006468-0
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
ROJAS MATAJUDIOS CARLOS ANDRES
31 . Clase
Importador
02
32 . Tipo declaración
Corrección
33 . Cod.
4
34 .No.Formulario Anterior
032025002177725
35 . Año – Mes – Día
2025 – 12 – 16
36 . Cod. Admón.
03
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
13907
42 . Manifiesto de carga
No. 9194671828
43 . Año – Mes – Día
2025 – 12 – 29
44 . Documento de transporte
No. SHAN0445466
45 . Año – Mes – Día
2025 – 12 – 13
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 1667
50 . E-mail
010-8705-6749
51 . No. de factura
9104002755
52 . Año – Mes – Día
2025 – 12 – 13
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.
3.810.99
S59 . Subpartida arancelaria
8517130000
60 . Cod.
Complementario
XX
61 . Cod.
Suplementario
XX
62 . Cod. Modalidad
C234
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.
155.50
72 . Peso neto kgs. dcms.
143.06
73 . Código
embalaje
YY
74 . No.
bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
500.00
78 .Valor FOB USD
29.039.84
79 . Valor fletes USD
1.374.62 Concepto % Base Total Liquidado ($)
Total a pagar con esta
declaración ($)
Total Liquidado
(USD)
Arancel
92
0.00
93
115.913.014
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
115.913.014
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
1.00
81 . Valor Otros Gastos USD
0
82 . Sumatoria de fletes, seguros
y otros gastos USD
1.375.62
83 . Ajuste valor USD
0.00
84 . Valor aduana USD
30.415.46
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: 584534-DECL: 1983793-DO: 893131123251- 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: 3105410224. ID DELIVERY: 6086155746. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A165MZKDLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A16 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: Después de insp.: levante
No hay declaración posterior
Acta de inspección No.: 032026000003623
Inició: 2026-01-06 08:33:49 Finalizó: 2026-01-08 10:08:00
131 . Espacio reservado uso exclusivo Ministerio de Relaciones Exteriores 132 . No. Aceptación declaración
032026000006468
133. Feha: 2026 01 02
134 . Levante No. 032026000040924 135 . Fecha
2026 – 01 – 08
Firma funcionario responsable 136 . Nombre MORALES FUENTES ELIECER DAVID
137 . C.C. No. 1017234312
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
996 . Espacio para autoadhesivo de la entidad recaudadora
(Número del adhesivo)
SYGA
Autoadhesivo 92032604255146
Fecha presentación 2026-01-02 14:57:21
Valor pagado $No se aplicó el pago
980 . Pago Total $
0
Fecha de Impresión: 2026-01-08 17:10:40
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000006468-0
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A165M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A165M/DS,BLACK,LTC( QTY. 500,00 u )(500,00 PCE
); IMEIS: 350558662265803/352871222265801. 350558662266256/352871222266254. 350558662266355/352871222266353. 350558662266470/3528
71222266478. 350558662266587/352871222266585. 350558662267528/352871222267526. 350558662269037/352871222269035. 350558662272429/3
52871222272427. 350558662340085/352871222340083.350558662340184/352871222340182. 350558662340366/352871222340364. 350558662341521
/352871222341529. 350558662342016/352871222342014. 350558662342099/352871222342097. 350558662342214/352871222342212. 350558662342
263/352871222342261. 350558662342446/352871222342444. 350558662342479/352871222342477. 350558662342594/352871222342592. 350558662
342610/352871222342618. 350558662342636/352871222342634. 350558662342669/352871222342667. 350558662342701/352871222342709. 350558
662342834/352871222342832. 350558662342842/352871222342840. 350558662343006/352871222343004 . 350558662343428/352871222343426. 35
0558662343568/352871222343566. 350558662343618/352871222343616. 350558662343659/352871222343657. 350558662343675/352871222343673.
350558662343717/352871222343715. 350558662343774/352871222343772. 350558662343923/352871222343921. 350558662343949/3528712223439
47. 350558662344095/352871222344093. 350558662344137/352871222344135. 350558662344160/352871222344168. 350558662344780/3528712223
44788. 350558662344814/352871222344812. 350558662344897/352871222344895. 350558662344913/352871222344911. 350558662344947/3528712
22344945. 350558662344970/352871222344978. 350558662344996/352871222344994. 350558662345001/352871222345009. 350558662345019/3528
71222345017. 350558662345167/352871222345165. 350558662345183/352871222345181. 350558662345332/352871222345330. 350558662345381/3
52871222345389. 350558662345399/352871222345397. 350558662345415/352871222345413. 350558662345423/352871222345421. 35055866234543
1/352871222345439. 350558662345449/352871222345447. 350558662345456/352871222345454. 350558662345464/352871222345462. 35055866234
5480/352871222345488. 350558662345506/352871222345504. 350558662345530/352871222345538. 350558662345548/352871222345546.350558662
345563/352871222345561. 350558662345589/352871222345587. 350558662345621/352871222345629. 350558662345662/352871222345660. 350558
662346116/352871222346114. 350558662346124/352871222346122. 350558662346132/352871222346130. 350558662346173/352871222346171. 350
558662346892/352871222346890. 350558662346967/352871222346965. 350558662347056/352871222347054. 350558662347114/352871222347112.
350558662347163/352871222347161. 350558662347247/352871222347245. 350558662347346/352871222347344. 350558662347791/35287122234779
9. 350558662347809/352871222347807.350558662348005/352871222348003. 350558662348013/352871222348011. 350558662348039/352871222348
037. 350558662348062/352871222348060. 350558662348070/352871222348078. 350558662348096/352871222348094. 350558662348112/352871222
348110. 350558662348120/352871222348128. 350558662348138/352871222348136. 350558662348146/352871222348144. 350558662348187/352871
222348185. 350558662348203/352871222348201. 350558662348211/352871222348219. 350558662348229/352871222348227. 350558662348237/352
871222348235. 350558662348245/352871222348243. 350558662348252/352871222348250. 350558662348260/352871222348268. 350558662348278/
352871222348276. 350558662348286/352871222348284. 350558662348294/352871222348292. 350558662348302/352871222348300. 3505586623483
10/352871222348318. 350558662348328/352871222348326. 350558662348336/352871222348334. 350558662348351/352871222348359. 3505586623
48369/352871222348367. 350558662348385/352871222348383. 350558662348393/352871222348391. 350558662348435/352871222348433. 3505586
62348443/352871222348441. 350558662348450/352871222348458. 350558662348468/352871222348466. 350558662348476/352871222348474. 3505
58662348526/352871222348524. 350558662348534/352871222348532. 350558662348542/352871222348540. 350558662348567/352871222348565. 3
50558662348575/352871222348573. 350558662348625/352871222348623. 350558662348633/352871222348631. 350558662348666/352871222348664
. 350558662348914/352871222348912. 350558662349128/352871222349126. 350558662349136/352871222349134. 350558662349268/352871222349
266. 350558662349292/352871222349290. 350558662349318/352871222349316. 350558662349359/352871222349357. 350558662349409/352871222
349407. 350558662349417/352871222349415. 350558662350290/352871222350298. 350558662350308/352871222350306.350558662350316/3528712
22350314. 350558662350365/352871222350363. 350558662350381/352871222350389. 350558662350480/352871222350488. 350558662350498/3528
71222350496. 350558662350548/352871222350546. 350558662350845/352871222350843. 350558662350852/352871222350850. 350558662350878/3
52871222350876. 350558662350894/352871222350892. 350558662350928/352871222350926. 350558662355158/352871222355156. 35055866235519
0/352871222355198. 350558662355331/352871222355339. 350558662355372/352871222355370. 350558662355455/352871222355453. 35055866235
5463/352871222355461.350558662355919/352871222355917. 350558662356446/352871222356444. 350558662356487/352871222356485. 350558662
356495/352871222356493. 350558662356503/352871222356501. 350558662356552/352871222356550. 350558662356560/352871222356568. 350558
662356586/352871222356584. 350558662356602/352871222356600. 350558662356636/352871222356634. 350558662356644/352871222356642. 350
558662356669/352871222356667. 350558662356677/352871222356675. 350558662356685/352871222356683. 350558662356693/352871222356691.
350558662356701/352871222356709. 350558662356719/352871222356717. 350558662356727/352871222356725. 350558662356735/35287122235673
3. 350558662356750/352871222356758. 350558662356776/352871222356774. 350558662356784/352871222356782. 350558662356792/35287122235
6790. 350558662357105/352871222357103. 350558662357113/352871222357111. 350558662357121/352871222357129. 350558662357147/35287122
2357145. 350558662357154/352871222357152. 350558662357204/352871222357202. 350558662357212/352871222357210. 350558662357600/35287
1222357608. 350558662357618/352871222357616. 350558662357626/352871222357624. 350558662357972/352871222357970. 350558662358004/35
2871222358002. 350558662358020/352871222358028. 350558662358103/352871222358101. 350558662358111/352871222358119. 350558662358152
/352871222358150. 350558662358434/352871222358432. 350558662358848/352871222358846. 350558662358905/352871222358903. 350558662358
988/352871222358986. 350558662359275/352871222359273. 350558662359838/352871222359836. 350558662360695/352871222360693. 350558662
362220/352871222362228. 350558662362352/352871222362350. 350558662362394/352871222362392. 350558662362444/352871222362442. 350558
662362501/352871222362509. 350558662362535/352871222362533. 350558662362543/352871222362541.350558662362634/352871222362632. 3505
58662362642/352871222362640. 350558662362675/352871222362673. 350558662362733/352871222362731. 350558662362741/352871222362749. 3
50558662362758/352871222362756. 350558662362808/352871222362806. 350558662362840/352871222362848. 350558662362857/352871222362855
. 350558662362949/352871222362947. 350558662362964/352871222362962. 350558662362980/352871222362988. 350558662363152/352871222363
150. 350558662363160/352871222363168. 350558662363178/352871222363176. 350558662363194/352871222363192. 350558662363202/352871222
363200.350558662363244/352871222363242. 350558662363269/352871222363267. 350558662363277/352871222363275. 350558662363293/3528712
22363291. 350558662363301/352871222363309. 350558662363343/352871222363341. 350558662363350/352871222363358. 350558662363384/3528
71222363382. 350558662363442/352871222363440. 350558662363467/352871222363465. 350558662363475/352871222363473. 350558662363616/3
52871222363614. 350558662363830/352871222363838. 350558662363913/352871222363911. 350558662363921/352871222363929. 35055866236404
4/352871222364042. 350558662364069/352871222364067. 350558662364093/352871222364091. 350558662364119/352871222364117. 35055866236
4499/352871222364497. 350558662364580/352871222364588. 350558662364622/352871222364620. 350558662364861/352871222364869. 35055866
2365090/352871222365098. 350558662365439/352871222365437. 350558662365595/352871222365593. 350558662366072/352871222366070. 35055
8662366171/352871222366179. 350558662366189/352871222366187. 350558662367039/352871222367037. 350558662367104/352871222367102. 35
0558662367138/352871222367136. 350558662367179/352871222367177. 350558662367591/352871222367599. 350558662368078/352871222368076.
350558662368722/352871222368720. 350558662368763/352871222368761. 350558662368961/352871222368969. 350558662369290/3528712223692
98. 350558662369415/352871222369413. 350558662369621/352871222369629. 350558662369639/352871222369637. 350558662369662/3528712223
69660. 350558662370157/352871222370155. 350558662370637/352871222370635. 350558662370645/352871222370643. 350558662370652/3528712
22370650. 350558662370686/352871222370684. 350558662370777/352871222370775. 350558662370785/352871222370783. 350558662370934/3528
71222370932. 350558662370942/352871222370940. 350558662370959/352871222370957.350558662371098/352871222371096. 350558662371163/35
2871222371161. 350558662371312/352871222371310. 350558662371932/352871222371930. 350558662472078/352871222472076. 350558662472086
/352871222472084. 350558662472102/352871222472100. 350558662472425/352871222472423. 350558662472458/352871222472456. 350558662472
821/352871222472829. 350558662472862/352871222472860. 350558662472912/352871222472910. 350558662473076/352871222473074. 350558662
473100/352871222473108. 350558662473209/352871222473207. 350558662473241/352871222473249. 350558662473340/352871222473348.3505586
032026000006468-0
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000006468-0
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
62473530/352871222473538. 350558662474124/352871222474122. 350558662474165/352871222474163. 350558662474181/352871222474189. 3505
58662474215/352871222474213. 350558662474223/352871222474221. 350558662474249/352871222474247. 350558662474256/352871222474254. 3
50558662474264/352871222474262. 350558662474280/352871222474288. 350558662474298/352871222474296. 350558662474306/352871222474304
. 350558662474314/352871222474312. 350558662474348/352871222474346. 350558662474355/352871222474353. 350558662474389/352871222474
387. 350558662474447/352871222474445. 350558662474488/352871222474486. 350558662474496/352871222474494. 350558662474520/352871222
474528. 350558662474595/352871222474593. 350558662474603/352871222474601. 350558662477994/352871222477992. 350558662478059/352871
222478057. 350558662479461/352871222479469. 350558662479867/352871222479865. 350558662479875/352871222479873. 350558662479966/352
871222479964. 350558662480295/352871222480293. 350558662480303/352871222480301. 350558662480311/352871222480319. 350558662480717/
352871222480715. 350558662480774/352871222480772. 350558662480840/352871222480848. 350558662480865/352871222480863. 3505586624808
73/352871222480871. 350558662480881/352871222480889. 350558662480907/352871222480905. 350558662480972/352871222480970. 3505586624
81079/352871222481077. 350558662486672/352871222486670. 350558662486680/352871222486688. 350558662486698/352871222486696. 3505586
62486706/352871222486704. 350558662486904/352871222486902. 350558662486987/352871222486985. 350558662487001/352871222487009. 3505
58662487027/352871222487025. 350558662487092/352871222487090. 350558662487100/352871222487108. 350558662487159/352871222487157. 3
50558662487167/352871222487165. 350558662487175/352871222487173.350558662487209/352871222487207. 350558662487225/352871222487223.
350558662487274/352871222487272. 350558662487290/352871222487298. 350558662487324/352871222487322. 350558662487340/3528712224873
48. 350558662487365/352871222487363. 350558662487399/352871222487397. 350558662487514/352871222487512. 350558662487522/3528712224
87520. 350558662487548/352871222487546. 350558662487555/352871222487553. 350558662487571/352871222487579. 350558662487597/3528712
22487595. 350558662487605/352871222487603. 350558662489312/352871222489310. 350558662489387/352871222489385.350558662489437/35287
1222489435. 350558662489445/352871222489443. 350558662489452/352871222489450. 350558662489460/352871222489468. 350558662489486/35
2871222489484. 350558662489650/352871222489658. 350558662489676/352871222489674. 350558662489692/352871222489690. 350558662489700
/352871222489708. 350558662489718/352871222489716. 350558662489726/352871222489724. 350558662489734/352871222489732. 350558662489
759/352871222489757. 350558662489767/352871222489765. 350558662489775/352871222489773. 350558662489783/352871222489781. 350558662
489791/352871222489799. 350558662489809/352871222489807. 350558662489833/352871222489831. 350558662489866/352871222489864. 350558
662489924/352871222489922. 350558662489981/352871222489989. 350558662490013/352871222490011. 350558662490039/352871222490037. 350
558662490047/352871222490045. 350558662490054/352871222490052. 350558662490062/352871222490060. 350558662490096/352871222490094.
350558662490104/352871222490102. 350558662490120/352871222490128. 350558662490146/352871222490144. 350558662490260/35287122249026
8. 350558662490278/352871222490276. 350558662490310/352871222490318. 350558662490369/352871222490367. 350558662490484/35287122249
0482. 350558662490518/352871222490516. 350558662490526/352871222490524. 350558662490534/352871222490532. 350558662490542/35287122
2490540. 350558662490567/352871222490565. 350558662490591/352871222490599. 350558662490609/352871222490607. 350558662490633/35287
1222490631. 350558662490641/352871222490649. 350558662490658/352871222490656. 350558662490666/352871222490664. 350558662490674/35
2871222490672. 350558662490682/352871222490680. 350558662490716/352871222490714. 350558662490724/352871222490722. 350558662490732
/352871222490730. 350558662490740/352871222490748.350558662490948/352871222490946. 350558662491011/352871222491019. 3505586624910
37/352871222491035. 350558662491045/352871222491043. 350558662491052/352871222491050. 350558662491060/352871222491068. 3505586624
91151/352871222491159. 350558662491177/352871222491175. 350558662491185/352871222491183. 350558662491227/352871222491225. 3505586
62491243/352871222491241. 350558662491359/352871222491357. 350558662491391/352871222491399. 350558662491425/352871222491423. 3505
58662491680/352871222491688. 350558662491714/352871222491712. 350558662491730/352871222491738.350558662491953/352871222491951. 35
0558662492092/352871222492090. 350558662492142/352871222492140. 350558662492159/352871222492157. 350558662492191/352871222492199.
350558662492217/352871222492215. 350558662492381/352871222492389. 350558662492571/352871222492579. 350558662492621/3528712224926
29. 350558662492670/352871222492678. 350558662492712/352871222492710. 350558662492720/352871222492728. 350558662492779/3528712224
92777. 350558662492837/352871222492835. 350558662492910/352871222492918. 350558662492985/352871222492983. 350558662492993/3528712
22492991. 350558662493017/352871222493015. 350558662493025/352871222493023. 350558662493140/352871222493148. 350558662493264/3528
71222493262. 350558662493397/352871222493395. 350558662493496/352871222493494. 350558662493538/352871222493536. 350558662494387/3
52871222494385. 350558662494429/352871222494427. 350558662494551/352871222494559. 350558662494858/352871222494856. 35055866249505
3/352871222495051. 350558662495186/352871222495184. 350558662495194/352871222495192. 350558662495210/352871222495218. 35055866249
5228/352871222495226. 350558662495269/352871222495267. 350558662495731/352871222495739. 350558662495780/352871222495788. 35055866
2496234/352871222496232. 350558662496275/352871222496273. 350558662496390/352871222496398. 350558662496515/352871222496513. 35055
8662496523/352871222496521. 350558662496655/352871222496653. 350558662497711/352871222497719. 350558662497729/352871222497727. 35
0558662497794/352871222497792. 350558662497810/352871222497818. 350558662497828/352871222497826. 350558662497836/352871222497834.
350558662497851/352871222497859. 350558662497869/352871222497867. 350558662498008/352871222498006. 350558662498248/3528712224982
46. 350558662498263/352871222498261.350558662498438/352871222498436. 350558662498537/352871222498535. 350558662498560/35287122249
8568. 350558662498594/352871222498592. 350558662498669/352871222498667. 350558662498685/352871222498683. 350558662498701/35287122
2498709. 350558662498727/352871222498725. 350558662498966/352871222498964. 350558662499089/352871222499087. 350558662499337/35287
1222499335. 350558662499469/352871222499467. 350558662499519/352871222499517. 350558662499543/352871222499541. 350558662499568/35
2871222499566. 350558662499659/352871222499657. 350558662499717/352871222499715.350558662501140/352871222501148XXXXXXXXXXXXXXXXXX
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032026000006468-0
Espacio para uso exclusivo de la Entidad Recaudadora
