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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
032025001948150-9
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. 116575016264458
43 . Año – Mes – Día
2025 – 11 – 07
44 . Documento de transporte
No. 41N0738577
45 . Año – Mes – Día
2025 – 11 – 01
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
6900396896
52 . Año – Mes – Día
2025 – 10 – 27
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
244
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
3.870.42
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.
118.00
72 . Peso neto kgs. dcms.
88.20
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
360.00
78 .Valor FOB
USD
23.048.34
79 . Valor fletes USD
775.26 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
92.210.396
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
92.210.396
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
0.79
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
776.05
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
23.824.39
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: 579667-DECL: 1970474-DO: 893127522251- 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: 3102008867. ID DELIVERY: 6085406546. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A075MLVHLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A07 5G 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
032025001948150
133. Feha: 202511 06
134 . Levante No. 032025001679076 135 . Fecha
2025 – 11 – 10
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 92032508728520
Fecha presentación 2025-11-06 19:22:41
Valor pagado $0.00
Fecha de Impresión: 2025-11-10 13:33:54
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001948150-9
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
CLARO, MODELO:SM-A075M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A075M/DS,LIGHT VIOLET,LTC( QTY. 360,00 u
)(360,00 PCE ); IMEIS: 352169185461073/354282525461071. 352169185461206/354282525461204. 352169185461479/354282525461477. 352169
185461495/354282525461493. 352169185461529/354282525461527. 352169185461586/354282525461584. 352169185461602/354282525461600. 352
169185461636/354282525461634. 352169185461669/354282525461667. 352169185461750/354282525461758. 352169185461800/354282525461808.
352169185461859/354282525461857. 352169185461867/354282525461865. 352169185461909/354282525461907. 352169185461917/35428252546191
5. 352169185461941/354282525461949. 352169185461966/354282525461964.352169185461974/354282525461972. 352169185461982/354282525461
980. 352169185462014/354282525462012. 352169185462055/354282525462053. 352169185462071/354282525462079. 352169185462204/354282525
462202. 352169185462238/354282525462236. 352169185462246/354282525462244. 352169185462279/ 354282525462277. 352169185462303/35428
2525462301. 352169185462329/354282525462327. 352169185462337/354282525462335. 352169185462352/354282525462350. 352169185462360/35
4282525462368. 352169185462386/354282525462384. 352169185462402/354282525462400. 352169185462485/354282525462483.352169185462493/
354282525462491. 352169185462519/354282525462517. 352169185462543/354282525462541. 352169185462568/354282525462566. 3521691854625
76/354282525462574. 352169185462584/354282525462582. 352169185462592/354282525462590. 352169185462600/354282525462608. 3521691854
62683/354282525462681. 352169185462709/354282525462707. 352169185462717/354282525462715. 352169185462758/354282525462756. 3521691
85462782/354282525462780. 352169185462808/354282525462806. 352169185462824/354282525462822. 352169185462873/354282525462871. 3521
69185463111/354282525463119. 352169185463145/354282525463143. 352169185463152/354282525463150. 352169185463418/354282525463416. 3
52169185463483/354282525463481. 352169185463517/354282525463515. 352169185463582/354282525463580. 352169185463616/354282525463614
. 352169185463624/354282525463622. 352169185463640/354282525463648. 352169185463657/354282525463655. 352169185463665/354282525463
663. 352169185463673/354282525463671. 352169185463764/354282525463762. 352169185463954/354282525463952. 352169185463962/354282525
463960. 352169185464010/354282525464018. 352169185464101/354282525464109. 352169185464143/354282525464141. 352169185464184/354282
525464182. 352169185464309/354282525464307. 352169185464317/354282525464315. 352169185464333/354282525464331. 352169185464366/354
282525464364. 352169185464374/354282525464372. 352169185464408/354282525464406. 352169185464416/354282525464414. 352169185464424/
354282525464422. 352169185464432/354282525464430. 352169185464457/354282525464455. 352169185464473/354282525464471. 3521691854644
81/354282525464489. 352169185464499/354282525464497. 352169185464507/354282525464505. 352169185464523/354282525464521. 3521691854
64531/354282525464539. 352169185464564/354282525464562.352169185464572/354282525464570. 352169185464804/354282525464802. 35216918
5464895/354282525464893. 352169185464903/354282525464901. 352169185464929/354282525464927. 352169185464945/354282525464943. 35216
9185464952/354282525464950. 352169185464978/354282525464976. 352169185464986/354282525464984. 352169185465017/354282525465015. 35
2169185465025/354282525465023. 352169185465033/354282525465031. 352169185465058/354282525465056. 352169185465082/354282525465080.
352169185465090/354282525465098. 352169185465116/354282525465114. 352169185465140/354282525465148.352169185465157/35428252546515
5. 352169185465181/354282525465189. 352169185465199/354282525465197. 352169185465207/354282525465205. 352169185465223/35428252546
5221. 352169185465256/354282525465254. 352169185465264/354282525465262. 352169185465330/354282525465338. 352169185465348/35428252
5465346. 352169185465355/354282525465353. 352169185465371/354282525465379. 352169185465397/354282525465395. 352169185465405/35428
2525465403. 352169185465413/354282525465411. 352169185465421/354282525465429. 352169185465439/354282525465437. 352169185465462/35
4282525465460. 352169185465470/354282525465478. 352169185465488/354282525465486. 352169185465496/354282525465494. 352169185465504
/354282525465502. 352169185465512/354282525465510. 352169185465520/354282525465528. 352169185465546/354282525465544. 352169185465
553/354282525465551. 352169185465579/354282525465577. 352169185465595/354282525465593. 352169185465611/354282525465619. 352169185
465629/354282525465627. 352169185465637/354282525465635. 352169185465645/354282525465643. 352169185465660/354282525465668. 352169
185465678/354282525465676. 352169185465710/354282525465718. 352169185465926/354282525465924. 352169185465983/354282525465981. 352
169185466023/354282525466021. 352169185466213/354282525466211. 352169185466536/354282525466534. 352169185466551/354282525466559.
352169185466668/354282525466666. 352169185466676/354282525466674. 352169185466692/354282525466690. 352169185466700/35428252546670
8. 352169185466726/354282525466724. 352169185466734/354282525466732. 352169185466742/354282525466740. 352169185466759/35428252546
6757. 352169185466775/354282525466773. 352169185466809/354282525466807. 352169185466825/354282525466823. 352169185466908/35428252
5466906. 352169185466932/354282525466930.352169185466965/354282525466963. 352169185466999/354282525466997. 352169185467047/354282
525467045. 352169185467070/354282525467078. 352169185467088/354282525467086. 352169185467120/354282525467128. 352169185467161/354
282525467169. 352169185467278/354282525467276. 352169185467294/354282525467292. 352169185467328/354282525467326. 352169185467336/
354282525467334. 352169185467369/354282525467367. 352169185467377/354282525467375. 352169185467393/354282525467391. 3521691854674
01/354282525467409. 352169185467427/354282525467425. 352169185467443/354282525467441.352169185467450/354282525467458. 35216918546
7468/354282525467466. 352169185467476/354282525467474. 352169185467492/354282525467490. 352169185467526/354282525467524. 35216918
5467534/354282525467532. 352169185467542/354282525467540. 352169185467567/354282525467565. 352169185467591/354282525467599. 35216
9185467609/354282525467607. 352169185467625/354282525467623. 352169185467633/354282525467631. 352169185467641/354282525467649. 35
2169185467658/354282525467656. 352169185467666/354282525467664. 352169185467674/354282525467672. 352169185467690/354282525467698.
352169185467708/354282525467706. 352169185467716/354282525467714. 352169185467724/354282525467722. 352169185467740/3542825254677
48. 352169185467765/354282525467763. 352169185467799/354282525467797. 352169185467849/354282525467847. 352169185467898/3542825254
67896. 352169185467906/354282525467904. 352169185467914/354282525467912. 352169185467922/354282525467920. 352169185468052/3542825
25468050. 352169185468060/354282525468068. 352169185468078/354282525468076. 352169185468094/354282525468092. 352169185468144/3542
82525468142. 352169185468169/354282525468167. 352169185468193/354282525468191. 352169185468326/354282525468324. 352169185468342/3
54282525468340. 352169185468375/354282525468373. 352169185468425/354282525468423. 352169185468474/354282525468472. 35216918546848
2/354282525468480. 352169185468532/354282525468530. 352169185468599/354282525468597. 352169185468722/354282525468720. 35216918546
8748/354282525468746. 352169185468839/354282525468837. 352169185468854/354282525468852. 352169185468862/354282525468860. 35216918
5468888/354282525468886. 352169185468946/354282525468944. 352169185469035/354282525469033. 352169185469282/354282525469280. 35216
9185469290/354282525469298.352169185469308/354282525469306. 352169185469324/354282525469322. 352169185469357/354282525469355. 352
169185469373/354282525469371. 352169185469399/354282525469397. 352169185469944/354282525469942. 352169185470033/354282525470031.
352169185470181/354282525470189. 352169185470215/354282525470213. 352169185470298/354282525470296. 352169185470314/35428252547031
2. 352169185470330/354282525470338. 352169185470348/354282525470346. 352169185470355/354282525470353. 352169185470363/35428252547
0361. 352169185470397/354282525470395. 352169185470454/354282525470452.352169185470470/354282525470478. 352169185470496/354282525
470494. 352169185470504/354282525470502. 352169185470538/354282525470536. 352169185470561/354282525470569. 352169185470587/354282
525470585. 352169185470611/354282525470619. 352169185470629/354282525470627. 352169185470637/354282525470635. 352169185470652/354
282525470650. 352169185470694/354282525470692. 352169185470736/354282525470734. 352169185470751/354282525470759. 352169185470769/
354282525470767. 352169185470777/354282525470775. 352169185470785/354282525470783. 352169185470827/354282525470825. 3521691854708
50/354282525470858. 352169185470876/354282525470874. 352169185470884/354282525470882. 352169185470900/354282525470908. 3521691854
70942/354282525470940. 352169185470959/354282525470957. 352169185471007/354282525471005. 352169185471015/354282525471013. 3521691
85471031/354282525471039. 352169185471072/354282525471070. 352169185471080/354282525471088. 352169185471122/354282525471120. 3521
69185471148/354282525471146. 352169185471155/354282525471153. 352169185471163/354282525471161. 352169185471171/354282525471179. 3
52169185471197/354282525471195. 352169185471205/354282525471203. 352169185471239/354282525471237. 352169185471288/354282525471286
. 352169185471338/354282525471336. 352169185471395/354282525471393. 352169185471437/354282525471435. 352169185471445/354282525471
443. 352169185471460/354282525471468. 352169185471478/354282525471476. 352169185471486/354282525471484. 352169185471494/354282525
032025001948150-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001948150-9
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
471492. 352169185471502/354282525471500. 352169185471528/354282525471526. 352169185471585/354282525471583. 352169185471593/354282
525471591. 352169185471627/354282525471625. 352169185471635/354282525471633. 352169185471643/354282525471641. 352169185471650/354
282525471658.352169185471668/354282525471666. 352169185471700/354282525471708. 352169185471718/354282525471716. 352169185471809/3
54282525471807. 352169185471858/354282525471856. 352169185471882/354282525471880. 352169185472054/354282525472052. 35216918547207
0/354282525472078. 352169185472211/354282525472219. 352169185472237/354282525472235. 352169185472260/354282525472268. 35216918547
2294/354282525472292. 352169185472310/354282525472318. 352169185472328/354282525472326. 352169185472450/354282525472458. 35216918
5472476/354282525472474. 352169185472492/354282525472490.352169185472500/354282525472508. 352169185472526/354282525472524. 352169
185472534/354282525472532. 352169185472542/354282525472540. 352169185472567/354282525472565. 352169185472575/354282525472573. 352
169185472625/354282525472623. 352169185472674/354282525472672. 352169185472716/354282525472714. 352169185472724/354282525472722.
352169185472781/354282525472789. 352169185472815/354282525472813. 352169185472856/354282525472854. 352169185472898/35428252547289
6. 352169185473110/354282525473118. 352169185473342/354282525473340. 352169185473425/354282525473423. 352169185473474/35428252547
3472. 352169185473607/354282525473605. 352169185473615/354282525473613. 352169185473623/354282525473621. 352169185473631/35428252
5473639. 352169185473656/354282525473654. 352169185473664/354282525473662. 352169185473672/354282525473670. 352169185473706/35428
2525473704. 352169185473714/354282525473712. 352169185473722/354282525473720. 352169185473797/354282525473795. 352169185473805/35
4282525473803. 352169185473813/354282525473811. 352169185473821/354282525473829. 352169185473839/354282525473837. 352169185473854
/354282525473852. 352169185473904/354282525473902. 352169185473912/354282525473910. 352169185473920/354282525473928. 352169185473
946/354282525473944. 352169185473979/354282525473977. 352169185474027/354282525474025. 352169185474076/354282525474074. 352169185
474084/354282525474082. 352169185474092/354282525474090. 352169185474100/354282525474108. 352169185474175/354282525474173. 352169
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032025001948150-9
Espacio para uso exclusivo de la Entidad Recaudadora
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