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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
032026000267374-6
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. 116575016693621
43 . Año – Mes – Día
2026 – 02 – 17
44 . Documento de transporte
No. DEL8199108
45 . Año – Mes – Día
2026 – 02 – 12
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
9104148013
52 . Año – Mes – Día
2026 – 02 – 12
53 . Cod. país
procedencia
361
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.
3.665.78
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
361
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.
162.00
72 . Peso neto kgs. dcms.
148.00
73 . Código
embalaje
YY
74 . No. bultos
2
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
500.00
78 .Valor FOB
USD
41.388.95
79 . Valor fletes USD
1.145.34 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
155.926.482
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
155.926.482
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
1.40
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.146.74
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
42.535.69
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: 591368-DECL: 2003125-DO: 893103701261- 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: 3109326421. ID DELIVERY: 6087158618. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A175FLBFLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A17 LTE DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL CL(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
032026000267374
133. Feha: 202602 18
134 . Levante No. 032026000244403 135 . Fecha
2026 – 02 – 18
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 92032605605018
Fecha presentación 2026-02-18 19:36:02
Valor pagado $0.00
Fecha de Impresión: 2026-02-18 19:36:10
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000267374-6
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ARO, MODELO: SM-A175F/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A175F/DS,LIGHT BLUE,LTC( QTY. 500,00 u )(
500,00 PCE ); IMEIS: 350901809151512/351461269151519. 350901809151587/351461269151584. 350901809151710/351461269151717. 350901809
151728/351461269151725. 350901809151736/351461269151733. 350901809151744/351461269151741. 350901809151751/351461269151758. 350901
809151769/351461269151766. 350901809151777/351461269151774. 350901809151785/351461269151782. 350901809151793/351461269151790. 350
901809151835/351461269151832. 350901809151850/351461269151857. 350901809151876/351461269151873. 350901809151884/351461269151881.3
50901809151892/351461269151899. 350901809151918/351461269151915. 350901809151926/351461269151923. 350901809151934/351461269151931
. 350901809151942/351461269151949. 350901809151959/351461269151956. 350901809151967/351461269151964. 350901809151975/351461269151
972. 350901809151983/351461269151980. 350901809151991/351461269151998. 350901809152007/3514 61269152004. 350901809152015/35146126
9152012. 350901809152023/351461269152020. 350901809152031/351461269152038. 350901809152049/351461269152046. 350901809152056/35146
1269152053. 350901809152064/351461269152061.350901809152072/351461269152079. 350901809152080/351461269152087. 350901809152098/351
461269152095. 350901809152106/351461269152103. 350901809152114/351461269152111. 350901809152122/351461269152129. 350901809152130/
351461269152137. 350901809152148/351461269152145. 350901809152155/351461269152152. 350901809152163/351461269152160. 3509018091521
89/351461269152186. 350901809152197/351461269152194. 350901809152205/351461269152202. 350901809152213/351461269152210. 3509018091
52221/351461269152228. 350901809152239/351461269152236. 350901809152247/351461269152244. 350901809152262/351461269152269. 3509018
09152270/351461269152277. 350901809152288/351461269152285. 350901809152304/351461269152301. 350901809152312/351461269152319. 3509
01809152320/351461269152327. 350901809152338/351461269152335. 350901809152346/351461269152343. 350901809152353/351461269152350. 3
50901809152361/351461269152368. 350901809152379/351461269152376. 350901809152387/351461269152384. 350901809152395/351461269152392
. 350901809152403/351461269152400. 350901809152411/351461269152418. 350901809152429/351461269152426. 350901809152437/351461269152
434. 350901809152452/351461269152459. 350901809152460/351461269152467. 350901809152478/351461269152475. 350901809152494/351461269
152491. 350901809152502/351461269152509. 350901809152528/351461269152525. 350901809152536/351461269152533. 350901809152544/351461
269152541. 350901809152551/351461269152558. 350901809152569/351461269152566. 350901809152577/351461269152574. 350901809152585/351
461269152582. 350901809152593/351461269152590. 350901809152601/351461269152608. 350901809152619/351461269152616. 350901809152627/
351461269152624. 350901809152734/351461269152731. 350901809152742/351461269152749. 350901809152759/351461269152756.35090180915277
5/351461269152772. 350901809152783/351461269152780. 350901809152791/351461269152798. 350901809152809/351461269152806. 35090180915
2817/351461269152814. 350901809152825/351461269152822. 350901809152833/351461269152830. 350901809152841/351461269152848. 35090180
9152858/351461269152855. 350901809152866/351461269152863. 350901809152874/351461269152871. 350901809152890/351461269152897. 35090
1809152908/351461269152905. 350901809152916/351461269152913. 350901809152924/351461269152921. 350901809152932/351461269152939. 35
0901809152940/351461269152947.350901809152957/351461269152954. 350901809152965/351461269152962. 350901809152973/351461269152970.
350901809152981/351461269152988. 350901809152999/351461269152996. 350901809153005/351461269153002. 350901809153013/35146126915301
0. 350901809153021/351461269153028. 350901809153211/351461269153218. 350901809153385/351461269153382. 350901809153443/35146126915
3440. 350901809153450/351461269153457. 350901809153476/351461269153473. 350901809153559/351461269153556. 350901809153617/35146126
9153614. 350901809153641/351461269153648. 350901809153690/351461269153697. 350901809153724/351461269153721. 350901809154359/35146
1269154356. 350901809154383/351461269154380. 350901809154425/351461269154422. 350901809154508/351461269154505. 350901809154698/35
1461269154695. 350901809154706/351461269154703. 350901809154797/351461269154794. 350901809156164/351461269156161. 350901809156347
/351461269156344. 350901809156354/351461269156351. 350901809156461/351461269156468. 350901809156487/351461269156484. 350901809156
503/351461269156500. 350901809156537/351461269156534. 350901809156800/351461269156807. 350901809157345/351461269157342. 350901809
157709/351461269157706. 350901809157733/351461269157730. 350901809157766/351461269157763. 350901809157824/351461269157821. 350901
809157840/351461269157847. 350901809157873/351461269157870. 350901809157881/351461269157888. 350901809157899/351461269157896. 350
901809157907/351461269157904. 350901809157923/351461269157920. 350901809157956/351461269157953. 350901809157972/351461269157979.
350901809157998/351461269157995. 350901809158020/351461269158027. 350901809158095/351461269158092. 350901809158111/35146126915811
8. 350901809158293/351461269158290. 350901809158301/351461269158308. 350901809158335/351461269158332.350901809158343/351461269158
340. 350901809158368/351461269158365. 350901809158418/351461269158415. 350901809158426/351461269158423. 350901809158434/351461269
158431. 350901809158467/351461269158464. 350901809158517/351461269158514. 350901809158525/351461269158522. 350901809158558/351461
269158555. 350901809158582/351461269158589. 350901809158590/351461269158597. 350901809158608/351461269158605. 350901809158616/351
461269158613. 350901809158699/351461269158696. 350901809158731/351461269158738. 350901809158749/351461269158746. 350901809158756/
351461269158753.350901809158798/351461269158795. 350901809158814/351461269158811. 350901809158855/351461269158852. 35090180915887
1/351461269158878. 350901809158897/351461269158894. 350901809158905/351461269158902. 350901809158939/351461269158936. 35090180915
8970/351461269158977. 350901809158996/351461269158993. 350901809159002/351461269159009. 350901809159036/351461269159033. 35090180
9159051/351461269159058. 350901809159085/351461269159082. 350901809159135/351461269159132. 350901809159176/351461269159173. 35090
1809159226/351461269159223. 350901809159309/351461269159306. 350901809159325/351461269159322. 350901809159416/351461269159413. 35
0901809159424/351461269159421. 350901809159630/351461269159637. 350901809159648/351461269159645. 350901809159705/351461269159702.
350901809159739/351461269159736. 350901809159747/351461269159744. 350901809159770/351461269159777. 350901809159788/3514612691597
85. 350901809159796/351461269159793. 350901809159820/351461269159827. 350901809159838/351461269159835. 350901809159846/3514612691
59843. 350901809159853/351461269159850. 350901809159861/351461269159868. 350901809159879/351461269159876. 350901809159887/3514612
69159884. 350901809159929/351461269159926. 350901809159937/351461269159934. 350901809159960/351461269159967. 350901809159978/3514
61269159975. 350901809160000/351461269160007. 350901809160042/351461269160049. 350901809160083/351461269160080. 350901809160091/3
51461269160098. 350901809160109/351461269160106. 350901809160166/351461269160163. 350901809160190/351461269160197. 35090180916021
6/351461269160213. 350901809160224/351461269160221. 350901809160299/351461269160296. 350901809160315/351461269160312. 35090180916
0331/351461269160338. 350901809160349/351461269160346. 350901809160380/351461269160387.350901809160398/351461269160395. 350901809
160406/351461269160403. 350901809160422/351461269160429. 350901809160471/351461269160478. 350901809160489/351461269160486. 350901
809160539/351461269160536. 350901809160661/351461269160668. 350901809160687/351461269160684. 350901809160703/351461269160700. 350
901809160711/351461269160718. 350901809160745/351461269160742. 350901809160760/351461269160767. 350901809160802/351461269160809.
350901809160810/351461269160817. 350901809160828/351461269160825. 350901809160919/351461269160916. 350901809160968/35146126916096
5.350901809161107/351461269161104. 350901809161131/351461269161138. 350901809161149/351461269161146. 350901809161156/351461269161
153. 350901809161214/351461269161211. 350901809161230/351461269161237. 350901809161271/351461269161278. 350901809161289/351461269
161286. 350901809161339/351461269161336. 350901809161354/351461269161351. 350901809161370/351461269161377. 350901809161446/351461
269161443. 350901809161453/351461269161450. 350901809161461/351461269161468. 350901809161495/351461269161492. 350901809161503/351
461269161500. 350901809161537/351461269161534. 350901809161552/351461269161559. 350901809161560/351461269161567. 350901809161578/
351461269161575. 350901809161636/351461269161633. 350901809161644/351461269161641. 350901809161651/351461269161658. 3509018091616
69/351461269161666. 350901809161693/351461269161690. 350901809161727/351461269161724. 350901809161743/351461269161740. 3509018091
61818/351461269161815. 350901809161867/351461269161864. 350901809161891/351461269161898. 350901809161925/351461269161922. 3509018
09161933/351461269161930. 350901809161941/351461269161948. 350901809161974/351461269161971. 350901809161982/351461269161989. 3509
01809161990/351461269161997. 350901809162006/351461269162003. 350901809162030/351461269162037. 350901809162071/351461269162078. 3
50901809162089/351461269162086. 350901809162105/351461269162102. 350901809162139/351461269162136. 350901809162147/351461269162144
. 350901809162154/351461269162151. 350901809162188/351461269162185. 350901809162212/351461269162219. 350901809162295/351461269162
032026000267374-6
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000267374-6
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
292. 350901809162311/351461269162318. 350901809162469/351461269162466. 350901809162493/351461269162490. 350901809162527/351461269
162524. 350901809162535/351461269162532. 350901809162592/351461269162599.350901809162618/351461269162615. 350901809162626/3514612
69162623. 350901809162642/351461269162649. 350901809162717/351461269162714. 350901809162758/351461269162755. 350901809162766/3514
61269162763. 350901809162774/351461269162771. 350901809162790/351461269162797. 350901809162857/351461269162854. 350901809162865/3
51461269162862. 350901809162899/351461269162896. 350901809162923/351461269162920. 350901809162931/351461269162938. 35090180916294
9/351461269162946. 350901809162956/351461269162953. 350901809162998/351461269162995. 350901809163012/351461269163019.350901809163
020/351461269163027. 350901809163038/351461269163035. 350901809163087/351461269163084. 350901809163095/351461269163092. 350901809
163228/351461269163225. 350901809163236/351461269163233. 350901809163244/351461269163241. 350901809163251/351461269163258. 350901
809163269/351461269163266. 350901809163277/351461269163274. 350901809163285/351461269163282. 350901809163293/351461269163290. 350
901809163301/351461269163308. 350901809163319/351461269163316. 350901809163327/351461269163324. 350901809163350/351461269163357.
350901809163368/351461269163365. 350901809163376/351461269163373. 350901809163400/351461269163407. 350901809163426/35146126916342
3. 350901809163442/351461269163449. 350901809163459/351461269163456. 350901809163467/351461269163464. 350901809163475/35146126916
3472. 350901809163509/351461269163506. 350901809163582/351461269163589. 350901809163590/351461269163597. 350901809163632/35146126
9163639. 350901809163657/351461269163654. 350901809163699/351461269163696. 350901809163715/351461269163712. 350901809163731/35146
1269163738. 350901809163749/351461269163746. 350901809163772/351461269163779. 350901809163780/351461269163787. 350901809163830/35
1461269163837. 350901809163905/351461269163902. 350901809163954/351461269163951. 350901809164051/351461269164058. 350901809164069
/351461269164066. 350901809164200/351461269164207. 350901809164325/351461269164322. 350901809164366/351461269164363. 350901809164
374/351461269164371. 350901809164382/351461269164389. 350901809164507/351461269164504. 350901809164523/351461269164520. 350901809
164531/351461269164538. 350901809164549/351461269164546. 350901809164598/351461269164595. 350901809164606/351461269164603. 350901
809164614/351461269164611. 350901809164671/351461269164678.350901809164747/351461269164744. 350901809164754/351461269164751. 3509
01809164804/351461269164801. 350901809164820/351461269164827. 350901809164838/351461269164835. 350901809164846/351461269164843. 3
50901809164853/351461269164850. 350901809164861/351461269164868. 350901809164895/351461269164892. 350901809164903/351461269164900
. 350901809164929/351461269164926. 350901809164960/351461269164967. 350901809164978/351461269164975. 350901809165041/351461269165
048. 350901809165082/351461269165089. 350901809165116/351461269165113. 350901809165124/351461269165121.350901809165132/3514612691
65139. 350901809165140/351461269165147. 350901809165157/351461269165154. 350901809165165/351461269165162. 350901809165173/3514612
69165170. 350901809165181/351461269165188. 350901809165199/351461269165196. 350901809165207/351461269165204. 350901809165215/3514
61269165212. 350901809165223/351461269165220. 350901809165249/351461269165246. 350901809165256/351461269165253. 350901809165306/3
51461269165303. 350901809165314/351461269165311. 350901809165322/351461269165329. 350901809165330/351461269165337. 35090180916534
8/351461269165345. 350901809165355/351461269165352. 350901809165363/351461269165360. 350901809165371/351461269165378. 35090180916
5389/351461269165386. 350901809165397/351461269165394. 350901809165405/351461269165402. 350901809165413/351461269165410. 35090180
9165421/351461269165428. 350901809165439/351461269165436. 350901809165447/351461269165444. 350901809165454/351461269165451. 35090
1809165462/351461269165469. 350901809165470/351461269165477. 350901809165488/351461269165485. 350901809165496/351461269165493. 35
0901809165520/351461269165527. 350901809165538/351461269165535. 350901809165561/351461269165568. 350901809165686/351461269165683.
350901809165694/351461269165691. 350901809165702/351461269165709. 350901809165736/351461269165733. 350901809165744/3514612691657
41. 350901809165751/351461269165758. 350901809165769/351461269165766. 350901809165777/351461269165774. 350901809165793/3514612691
65790. 350901809165801/351461269165808. 350901809165843/351461269165840. 350901809165850/351461269165857. 350901809165868/3514612
69165865. 350901809165892/351461269165899. 350901809165900/351461269165907. 350901809165942/351461269165949. 350901809166064/3514
61269166061. 350901809166072/351461269166079.350901809166163/351461269166160. 350901809166171/351461269166178. 350901809166189/35
1461269166186. 350901809166197/351461269166194. 350901809166205/351461269166202. 350901809166213/351461269166210. 350901809166221
/351461269166228. 350901809166239/351461269166236. 350901809166254/351461269166251. 350901809166338/351461269166335. 350901809166
346/351461269166343. 350901809166353/351461269166350. 350901809166361/351461269166368. 350901809166379/351461269166376. 350901809
166387/351461269166384. 350901809166395/351461269166392. 350901809166403/351461269166400.350901809166411/351461269166418. 3509018
09166429/351461269166426. 350901809166437/351461269166434. 350901809191245/351461269191242. 350901809191252/351461269191259. 3509
01809191260/351461269191267. 350901809191278/351461269191275. 350901809191286/351461269191283. 350901809191294/351461269191291. 3
50901809191302/351461269191309. 350901809191310/351461269191317. 350901809191328/351461269191325. 350901809191336/351461269191333
. 350901809191344/351461269191341. 350901809191351/351461269191358. 350901809191369/351461269191366. 350901809191385/351461269191
382. 350901809191393/351461269191390. 350901809191401/351461269191408. 350901809191419/351461269191416. 350901809191427/351461269
191424. 350901809191435/351461269191432. 350901809191443/351461269191440. 350901809191450/351461269191457. 350901809191468/351461
269191465. 350901809191476/351461269191473. 350901809191484/351461269191481. 350901809191492/351461269191499. 350901809191500/351
461269191507. 350901809191518/351461269191515. 350901809191526/351461269191523. 350901809191534/351461269191531. 350901809191559/
351461269191556. 350901809191567/351461269191564. 350901809191575/351461269191572. 350901809191583/351461269191580. 3509018091915
91/351461269191598. 350901809191609/351461269191606. 350901809191617/351461269191614. 350901809191625/351461269191622. 3509018091
91633/351461269191630. 350901809191658/351461269191655. 350901809191674/351461269191671. 350901809191682/351461269191689. 3509018
09191708/351461269191705. 350901809191716/351461269191713. 350901809191724/351461269191721. 350901809191732/351461269191739XXXXXX
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032026000267374-6
Espacio para uso exclusivo de la Entidad Recaudadora
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