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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
032026000006635-4
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
032025002181786
35 . Año – Mes – Día
2025 – 12 – 17
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. 9194671815
43 . Año – Mes – Día
2025 – 12 – 29
44 . Documento de transporte
No. SHAN0445473
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
9104002762
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.
156.00
72 . Peso neto kgs. dcms.
143.52
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
29.035.42
79 . Valor fletes USD
1.379.04 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
1.380.04
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: 584544-DECL: 1983838-DO: 893131130251- 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
RESOLUCIÓN 5050 DEL 10 DE NOVIEMBRE DE 2016. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOM
OLOGACIÓN) // NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION.SAMSUNG ELECTRONICS COLOMB
IA S.A. OEA COD. OE0001. . PEDIDOS: 3105398184. ID DELIVERY: 6086154452. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A165MZADLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A16 5G Duos (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: GRIS, (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
032026000006635
133. Feha: 2026 01 02
134 . Levante No. 032026000006427 135 . Fecha
2026 – 01 – 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
996 . Espacio para autoadhesivo de la entidad recaudadora
(Número del adhesivo)
SYGA
Autoadhesivo 92032604256380
Fecha presentación 2026-01-02 15:10:44
Valor pagado $No se aplicó el pago
980 . Pago Total $
0
Fecha de Impresión: 2026-01-02 15:11:49
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000006635-4
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MODELO: SM-A165M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A165M/DS,GRAY,LTC( QTY. 500,00 u )(500,00 PCE
); IMEIS: 350558662229890/352871222229898. 350558662229973/352871222229971. 350558662230039/352871222230037. 350558662230088/3528
71222230086. 350558662230112/352871222230110. 350558662230120/352871222230128. 350558662230419/352871222230417. 350558662230450/3
52871222230458. 350558662230914/352871222230912.350558662231052/352871222231050. 350558662231060/352871222231068. 350558662231128
/352871222231126. 350558662231979/352871222231977. 350558662232548/352871222232546. 350558662233041/352871222233049. 350558662233
215/352871222233213. 350558662233397/352871222233395. 350558662234015/352871222234013. 350558662234429/352871222234427. 350558662
234981/352871222234989. 350558662235988/352871222235986. 350558662236457/352871222236455. 350558662237596/352871222237594. 350558
662238248/352871222238246. 350558662238982/352871222238980. 350558662240772/352871222240770. 350558662240814/352871222240812. 350
558662240822/352871222240820. 350558662240962/352871222240960. 350558662241044/352871222241042. 350558662241960/352871222241968.
350558662242059/352871222242057. 350558662242497/352871222242495. 350558662244519/352871222244517. 350558662245052/35287122224505
0. 350558662245185/352871222245183. 350558662245235/352871222245233. 350558662245417/352871222245415. 350558662245532/35287122224
5530. 350558662246449/352871222246447. 350558662246720/352871222246728. 350558662246779/352871222246777. 350558662246811/35287122
2246819. 350558662247785/352871222247783. 350558662248189/352871222248187. 350558662249161/352871222249169. 350558662250607/35287
1222250605. 350558662250698/352871222250696. 350558662250748/352871222250746. 350558662251373/352871222251371. 350558662251548/35
2871222251546. 350558662251555/352871222251553. 350558662252215/352871222252213. 350558662252231/352871222252239. 350558662252611
/352871222252619. 350558662253171/352871222253179. 350558662253221/352871222253229. 350558662253262/352871222253260. 350558662253
270/352871222253278. 350558662253288/352871222253286. 350558662253445/352871222253443. 350558662253452/352871222253450. 350558662
253460/352871222253468. 350558662253767/352871222253765. 350558662253775/352871222253773. 350558662253940/352871222253948. 350558
662254039/352871222254037. 350558662254849/352871222254847. 350558662255721/352871222255729. 350558662256091/352871222256099. 350
558662256125/352871222256123. 350558662256281/352871222256289. 350558662256315/352871222256313. 350558662256364/352871222256362.
350558662258345/352871222258343. 350558662258352/352871222258350. 350558662258949/352871222258947. 350558662260465/35287122226046
3. 350558662261125/352871222261123.350558662261281/352871222261289. 350558662263816/352871222263814. 350558662264665/352871222264
663. 350558662265167/352871222265165. 350558662265399/352871222265397. 350558662306821/352871222306829. 350558662307381/352871222
307389. 350558662307415/352871222307413. 350558662307449/352871222307447. 350558662307464/352871222307462. 350558662307472/352871
222307470. 350558662307530/352871222307538. 350558662307548/352871222307546. 350558662307597/352871222307595. 350558662307605/352
871222307603. 350558662307613/352871222307611. 350558662307670/352871222307678.350558662307720/352871222307728. 350558662307753/3
52871222307751. 350558662307761/352871222307769. 350558662307969/352871222307967. 350558662308223/352871222308221. 35055866230825
6/352871222308254. 350558662308272/352871222308270. 350558662308314/352871222308312. 350558662308330/352871222308338. 35055866230
8348/352871222308346. 350558662308413/352871222308411. 350558662308504/352871222308502. 350558662308868/352871222308866. 35055866
2308983/352871222308981. 350558662310153/352871222310151. 350558662310328/352871222310326. 350558662310575/352871222310573. 35055
8662310666/352871222310664. 350558662310674/352871222310672. 350558662310872/352871222310870. 350558662310997/352871222310995. 35
0558662311011/352871222311019. 350558662311276/352871222311274. 350558662312068/352871222312066. 350558662312134/352871222312132.
350558662312159/352871222312157. 350558662312191/352871222312199. 350558662312209/352871222312207. 350558662312233/3528712223122
31. 350558662312241/352871222312249. 350558662312282/352871222312280. 350558662312290/352871222312298. 350558662312514/3528712223
12512. 350558662312563/352871222312561. 350558662312597/352871222312595. 350558662312753/352871222312751. 350558662312787/3528712
22312785. 350558662312795/352871222312793. 350558662312829/352871222312827. 350558662312878/352871222312876. 350558662312969/3528
71222312967. 350558662313025/352871222313023. 350558662313223/352871222313221. 350558662313322/352871222313320. 350558662313348/3
52871222313346. 350558662313579/352871222313577. 350558662313678/352871222313676. 350558662313686/352871222313684. 35055866231370
2/352871222313700. 350558662313751/352871222313759. 350558662313785/352871222313783. 350558662313793/352871222313791. 35055866231
3934/352871222313932.350558662313942/352871222313940. 350558662313975/352871222313973. 350558662313983/352871222313981. 350558662
314205/352871222314203. 350558662314254/352871222314252. 350558662314270/352871222314278. 350558662314304/352871222314302. 350558
662314353/352871222314351. 350558662314361/352871222314369. 350558662314387/352871222314385. 350558662314429/352871222314427. 350
558662314593/352871222314591. 350558662314718/352871222314716. 350558662314734/352871222314732. 350558662314742/352871222314740.
350558662314775/352871222314773. 350558662314783/352871222314781.350558662315038/352871222315036. 350558662315046/352871222315044
. 350558662315053/352871222315051. 350558662315061/352871222315069. 350558662315079/352871222315077. 350558662315087/352871222315
085. 350558662315111/352871222315119. 350558662315137/352871222315135. 350558662315152/352871222315150. 350558662315160/352871222
315168. 350558662315210/352871222315218. 350558662315244/352871222315242. 350558662315251/352871222315259. 350558662315269/352871
222315267. 350558662315277/352871222315275. 350558662315285/352871222315283. 350558662315327/352871222315325. 350558662315350/352
871222315358. 350558662315368/352871222315366. 350558662315376/352871222315374. 350558662315418/352871222315416. 350558662315434/
352871222315432. 350558662315459/352871222315457. 350558662315475/352871222315473. 350558662315509/352871222315507. 3505586623155
17/352871222315515. 350558662315558/352871222315556. 350558662315608/352871222315606. 350558662315616/352871222315614. 3505586623
15624/352871222315622. 350558662315632/352871222315630. 350558662315640/352871222315648. 350558662315665/352871222315663. 3505586
62316036/352871222316034. 350558662316069/352871222316067. 350558662316093/352871222316091. 350558662316127/352871222316125. 3505
58662316325/352871222316323. 350558662316358/352871222316356. 350558662316390/352871222316398. 350558662316408/352871222316406. 3
50558662316416/352871222316414. 350558662316432/352871222316430. 350558662316473/352871222316471. 350558662316515/352871222316513
. 350558662316523/352871222316521. 350558662316531/352871222316539. 350558662316549/352871222316547. 350558662316556/352871222316
554. 350558662316564/352871222316562. 350558662316580/352871222316588. 350558662316606/352871222316604. 350558662316655/352871222
316653.350558662316663/352871222316661. 350558662316671/352871222316679. 350558662316788/352871222316786. 350558662316796/3528712
22316794. 350558662316804/352871222316802. 350558662316838/352871222316836. 350558662316903/352871222316901. 350558662316911/3528
71222316919. 350558662316937/352871222316935. 350558662316945/352871222316943. 350558662316952/352871222316950. 350558662316960/3
52871222316968. 350558662316986/352871222316984. 350558662316994/352871222316992. 350558662317000/352871222317008. 35055866231706
7/352871222317065. 350558662317075/352871222317073.350558662317208/352871222317206. 350558662317364/352871222317362. 350558662317
554/352871222317552. 350558662317927/352871222317925. 350558662317935/352871222317933. 350558662318610/352871222318618. 350558662
318644/352871222318642. 350558662318677/352871222318675. 350558662318685/352871222318683. 350558662318727/352871222318725. 350558
662318735/352871222318733. 350558662318743/352871222318741. 350558662318750/352871222318758. 350558662318768/352871222318766. 350
558662318776/352871222318774. 350558662318800/352871222318808. 350558662318834/352871222318832. 350558662318925/352871222318923.
350558662318966/352871222318964. 350558662319030/352871222319038. 350558662319154/352871222319152. 350558662319196/35287122231919
4. 350558662319519/352871222319517. 350558662319550/352871222319558. 350558662319592/352871222319590. 350558662319600/35287122231
9608. 350558662319618/352871222319616. 350558662319642/352871222319640. 350558662319667/352871222319665. 350558662319683/35287122
2319681. 350558662319709/352871222319707. 350558662319881/352871222319889. 350558662320038/352871222320036. 350558662320343/35287
1222320341. 350558662320491/352871222320499. 350558662320541/352871222320549. 350558662320566/352871222320564. 350558662320608/35
2871222320606. 350558662320772/352871222320770. 350558662320798/352871222320796. 350558662320814/352871222320812. 350558662320947
/352871222320945. 350558662321002/352871222321000. 350558662321044/352871222321042. 350558662321077/352871222321075. 350558662321
085/352871222321083. 350558662321119/352871222321117. 350558662321127/352871222321125. 350558662321135/352871222321133. 350558662
321143/352871222321141. 350558662321150/352871222321158. 350558662321168/352871222321166. 350558662321176/352871222321174.3505586
032026000006635-4
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000006635-4
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
62321192/352871222321190. 350558662321234/352871222321232. 350558662321366/352871222321364. 350558662321374/352871222321372. 3505
58662321382/352871222321380. 350558662321390/352871222321398. 350558662321457/352871222321455. 350558662321481/352871222321489. 3
50558662321614/352871222321612. 350558662321648/352871222321646. 350558662321689/352871222321687. 350558662321697/352871222321695
. 350558662321838/352871222321836. 350558662321879/352871222321877. 350558662321887/352871222321885. 350558662321895/352871222321
893. 350558662322083/352871222322081.350558662322091/352871222322099. 350558662322133/352871222322131. 350558662322216/3528712223
22214. 350558662322315/352871222322313. 350558662322471/352871222322479. 350558662322539/352871222322537. 350558662322570/3528712
22322578. 350558662322653/352871222322651. 350558662322661/352871222322669. 350558662322893/352871222322891. 350558662323008/3528
71222323006. 350558662323719/352871222323717. 350558662323743/352871222323741. 350558662323776/352871222323774. 350558662323859/3
52871222323857. 350558662323867/352871222323865. 350558662323941/352871222323949. 350558662323958/352871222323956. 35055866232400
6/352871222324004. 350558662324014/352871222324012. 350558662324022/352871222324020. 350558662324048/352871222324046. 35055866232
4055/352871222324053. 350558662324071/352871222324079. 350558662324089/352871222324087. 350558662324113/352871222324111. 35055866
2324139/352871222324137. 350558662324303/352871222324301. 350558662324311/352871222324319. 350558662324329/352871222324327. 35055
8662324428/352871222324426. 350558662324436/352871222324434. 350558662324485/352871222324483. 350558662324493/352871222324491. 35
0558662324501/352871222324509. 350558662324535/352871222324533. 350558662324592/352871222324590. 350558662324618/352871222324616.
350558662324675/352871222324673. 350558662324717/352871222324715. 350558662324725/352871222324723. 350558662324774/3528712223247
72. 350558662324824/352871222324822. 350558662324923/352871222324921. 350558662324980/352871222324988. 350558662325029/3528712223
25027. 350558662325094/352871222325092. 350558662325151/352871222325159. 350558662325169/352871222325167. 350558662325201/3528712
22325209. 350558662325243/352871222325241. 350558662325581/352871222325589. 350558662325706/352871222325704.350558662325763/35287
1222325761. 350558662325789/352871222325787. 350558662325797/352871222325795. 350558662325839/352871222325837. 350558662326118/35
2871222326116. 350558662326126/352871222326124. 350558662326167/352871222326165. 350558662326266/352871222326264. 350558662326431
/352871222326439. 350558662326449/352871222326447. 350558662326621/352871222326629. 350558662326647/352871222326645. 350558662326
829/352871222326827. 350558662326852/352871222326850. 350558662326886/352871222326884. 350558662326936/352871222326934. 350558662
326977/352871222326975.350558662327173/352871222327171. 350558662327322/352871222327320. 350558662327389/352871222327387. 3505586
62327439/352871222327437. 350558662327462/352871222327460. 350558662327553/352871222327551. 350558662327561/352871222327569. 3505
58662327579/352871222327577. 350558662327587/352871222327585. 350558662327595/352871222327593. 350558662327603/352871222327601. 3
50558662327645/352871222327643. 350558662327660/352871222327668. 350558662327744/352871222327742. 350558662327835/352871222327833
. 350558662328023/352871222328021. 350558662328056/352871222328054. 350558662328072/352871222328070. 350558662328130/352871222328
138. 350558662328221/352871222328229. 350558662328254/352871222328252. 350558662328262/352871222328260. 350558662328304/352871222
328302. 350558662328320/352871222328328. 350558662328650/352871222328658. 350558662328668/352871222328666. 350558662328676/352871
222328674. 350558662328692/352871222328690. 350558662328700/352871222328708. 350558662328957/352871222328955. 350558662328999/352
871222328997. 350558662329039/352871222329037. 350558662329146/352871222329144. 350558662329161/352871222329169. 350558662329195/
352871222329193. 350558662329302/352871222329300. 350558662329443/352871222329441. 350558662329450/352871222329458. 3505586623294
68/352871222329466. 350558662329492/352871222329490. 350558662329542/352871222329540. 350558662329583/352871222329581. 3505586623
29674/352871222329672. 350558662329708/352871222329706. 350558662329716/352871222329714. 350558662329724/352871222329722. 3505586
62330136/352871222330134. 350558662330201/352871222330209. 350558662330219/352871222330217. 350558662330599/352871222330597. 3505
58662330615/352871222330613. 350558662330888/352871222330886. 350558662330946/352871222330944.350558662330953/352871222330951. 35
0558662330979/352871222330977. 350558662330987/352871222330985. 350558662330995/352871222330993. 350558662331076/352871222331074.
350558662331084/352871222331082. 350558662331373/352871222331371. 350558662331514/352871222331512. 350558662331548/3528712223315
46. 350558662331878/352871222331876. 350558662332132/352871222332130. 350558662332157/352871222332155. 350558662332165/3528712223
32163. 350558662332199/352871222332197. 350558662332405/352871222332403. 350558662332447/352871222332445. 350558662332454/3528712
22332452.350558662332470/352871222332478. 350558662332488/352871222332486. 350558662332512/352871222332510. 350558662332801/35287
1222332809. 350558662332827/352871222332825. 350558662333056/352871222333054. 350558662333072/352871222333070. 350558662333171/35
2871222333179. 350558662333213/352871222333211. 350558662333585/352871222333583. 350558662333809/352871222333807. 350558662333999
/352871222333997. 350558662334070/352871222334078. 350558662334088/352871222334086. 350558662334096/352871222334094. 350558662334
138/352871222334136. 350558662334559/352871222334557. 350558662334567/352871222334565. 350558662334666/352871222334664. 350558662
334732/352871222334730. 350558662335143/352871222335141. 350558662335176/352871222335174. 350558662335192/352871222335190. 350558
662335218/352871222335216. 350558662335242/352871222335240. 350558662335259/352871222335257. 350558662335267/352871222335265. 350
558662335317/352871222335315. 350558662335515/352871222335513. 350558662335622/352871222335620. 350558662335663/352871222335661.
350558662335846/352871222335844. 350558662336380/352871222336388. 350558662336992/352871222336990. 350558662337495/35287122233749
3. 350558662337701/352871222337709. 350558662337727/352871222337725. 350558662338428/352871222338426. 350558662338741/35287122233
8749. 350558662338915/352871222338913. 350558662338949/352871222338947. 350558662338980/352871222338988. 350558662339004/35287122
2339002. 350558662339012/352871222339010. 350558662339269/352871222339267. 350558662339368/352871222339366. 350558662339426/35287
1222339424. 350558662339442/352871222339440. 350558662339723/352871222339721. 350558662339756/352871222339754. 350558662339822/35
2871222339820. 350558662339855/352871222339853. 350558662725863/352871222725861.350558662725897/352871222725895XXXXXXXXXXXXXXXXXX
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032026000006635-4
Espacio para uso exclusivo de la Entidad Recaudadora
