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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
032026000381574-1
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. 116575016787193
43 . Año – Mes – Día
2026 – 03 – 10
44 . Documento de transporte
No. SHAN0471911
45 . Año – Mes – Día
2026 – 03 – 06
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
9104192016
52 . Año – Mes – Día
2026 – 03 – 06
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.
3.767.94
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
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.
143.00
72 . Peso neto kgs. dcms.
105.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
375.00
78 .Valor FOB
USD
84.361.63
79 . Valor fletes USD
1.162.59 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
322.260.755
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
322.260.755
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
2.82
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.165.41
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
85.527.04
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: 593803-DECL: 2009761-DO: 893105588261- 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: 3110579961. ID DELIVERY: 6087476670. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A376BLVKLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A37 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
032026000381574
133. Feha: 202603 11
134 . Levante No. 032026000348802 135 . Fecha
2026 – 03 – 11
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 92032606203145
Fecha presentación 2026-03-11 19:35:26
Valor pagado $0.00
Fecha de Impresión: 2026-03-11 19:35:30
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000381574-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
CLARO,MODELO: SM-A376B/DS,USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A376B/DS,LIGHT VIOLET,LTC( QTY. 375,00 u )
(375,00 PCE ); IMEIS: 356599700281984/356975820281981. 356599700281992/356975820281999. 356599700282032/356975820282039. 35659970
0282107/356975820282104. 356599700282123/356975820282120. 356599700282131/356975820282138. 356599700282149/356975820282146. 35659
9700282198/356975820282195. 356599700282206/356975820282203. 356599700282248/356975820282245. 356599700282255/356975820282252. 35
6599700349476/356975820349473. 356599700349484/356975820349481. 356599700349526/356975820349523. 356599700349534/356975820349531.
356599700349575/356975820349572. 356599700349591/356975820349598. 356599700349609/356975820349606. 356599700349625/35697582034962
2. 356599700349633/356975820349630. 356599700349658/356975820349655. 356599700349666/356975820349663. 356599700349674/35697582034
9671. 356599700349690/356975820349697. 356599700349716/356975820349713. 356599700349724/356 975820349721. 356599700349732/3569758
20349739. 356599700349740/356975820349747. 356599700349757/356975820349754. 356599700349765/356975820349762. 356599700349781/3569
75820349788. 356599700349799/356975820349796. 356599700349823/356975820349820. 356599700349849/356975820349846. 356599700349856/3
56975820349853. 356599700349864/356975820349861. 356599700349906/356975820349903. 356599700349914/356975820349911. 35659970034992
2/356975820349929. 356599700349930/356975820349937. 356599700349948/356975820349945. 356599700349989/356975820349986. 35659970035
0003/356975820350000. 356599700350011/356975820350018. 356599700350029/356975820350026. 356599700350037/356975820350034. 35659970
0350045/356975820350042. 356599700350052/356975820350059. 356599700350060/356975820350067. 356599700350086/356975820350083. 35659
9700350094/356975820350091. 356599700350110/356975820350117. 356599700350169/356975820350166. 356599700350177/356975820350174. 35
6599700350185/356975820350182. 356599700350219/356975820350216. 356599700350235/356975820350232. 356599700350243/356975820350240.
356599700350276/356975820350273. 356599700350292/356975820350299. 356599700350300/356975820350307. 356599700350342/3569758203503
49. 356599700350359/356975820350356. 356599700350367/356975820350364. 356599700350375/356975820350372. 356599700350409/3569758203
50406. 356599700350425/356975820350422. 356599700350433/356975820350430.356599700350441/356975820350448. 356599700350458/35697582
0350455. 356599700350466/356975820350463. 356599700350482/356975820350489. 356599700350490/356975820350497. 356599700350508/35697
5820350505. 356599700350516/356975820350513. 356599700350524/356975820350521. 356599700350532/356975820350539. 356599700350540/35
6975820350547. 356599700350557/356975820350554. 356599700350573/356975820350570. 356599700350581/356975820350588. 356599700350599
/356975820350596. 356599700350607/356975820350604. 356599700350615/356975820350612. 356599700350623/356975820350620.3565997003506
31/356975820350638. 356599700350649/356975820350646. 356599700350664/356975820350661. 356599700350680/356975820350687. 3565997003
50755/356975820350752. 356599700350789/356975820350786. 356599700350797/356975820350794. 356599700350821/356975820350828. 3565997
00350839/356975820350836. 356599700350847/356975820350844. 356599700350862/356975820350869. 356599700350870/356975820350877. 3565
99700350896/356975820350893. 356599700350920/356975820350927. 356599700350938/356975820350935. 356599700350946/356975820350943. 3
56599700350961/356975820350968. 356599700350979/356975820350976. 356599700351001/356975820351008. 356599700351050/356975820351057
. 356599700351084/356975820351081. 356599700351092/356975820351099. 356599700351126/356975820351123. 356599700351142/356975820351
149. 356599700351183/356975820351180. 356599700351217/356975820351214. 356599700351332/356975820351339. 356599700351399/356975820
351396. 356599700351415/356975820351412. 356599700351449/356975820351446. 356599700351530/356975820351537. 356599700351571/356975
820351578. 356599700351688/356975820351685. 356599700351795/356975820351792. 356599700351837/356975820351834. 356599700351845/356
975820351842. 356599700351902/356975820351909. 356599700351910/356975820351917. 356599700351936/356975820351933. 356599700351951/
356975820351958. 356599700351969/356975820351966. 356599700351985/356975820351982. 356599700351993/356975820351990. 3565997003520
17/356975820352014. 356599700352025/356975820352022. 356599700352033/356975820352030. 356599700352041/356975820352048. 3565997003
52090/356975820352097. 356599700352108/356975820352105. 356599700352124/356975820352121. 356599700352132/356975820352139. 3565997
00352140/356975820352147. 356599700352165/356975820352162.356599700352215/356975820352212. 356599700352249/356975820352246. 35659
9700352272/356975820352279. 356599700352280/356975820352287. 356599700352298/356975820352295. 356599700352330/356975820352337. 35
6599700352348/356975820352345. 356599700352355/356975820352352. 356599700352363/356975820352360. 356599700352389/356975820352386.
356599700352397/356975820352394. 356599700352413/356975820352410. 356599700352439/356975820352436. 356599700352447/3569758203524
44. 356599700352454/356975820352451. 356599700352470/356975820352477. 356599700352488/356975820352485.356599700352504/35697582035
2501. 356599700352512/356975820352519. 356599700352520/356975820352527. 356599700352538/356975820352535. 356599700352546/35697582
0352543. 356599700352553/356975820352550. 356599700352561/356975820352568. 356599700352579/356975820352576. 356599700352587/35697
5820352584. 356599700352595/356975820352592. 356599700352603/356975820352600. 356599700352611/356975820352618. 356599700352629/35
6975820352626. 356599700352645/356975820352642. 356599700352660/356975820352667. 356599700352686/356975820352683. 356599700352694
/356975820352691. 356599700352702/356975820352709. 356599700352728/356975820352725. 356599700352744/356975820352741. 356599700352
751/356975820352758. 356599700352769/356975820352766. 356599700352777/356975820352774. 356599700352793/356975820352790. 356599700
352819/356975820352816. 356599700352835/356975820352832. 356599700352850/356975820352857. 356599700352926/356975820352923. 356599
700352942/356975820352949. 356599700352959/356975820352956. 356599700352975/356975820352972. 356599700352991/356975820352998. 356
599700353007/356975820353004. 356599700353023/356975820353020. 356599700353064/356975820353061. 356599700353080/356975820353087.
356599700353098/356975820353095. 356599700353114/356975820353111. 356599700353205/356975820353202. 356599700353254/35697582035325
1. 356599700353270/356975820353277. 356599700353296/356975820353293. 356599700353320/356975820353327. 356599700353338/35697582035
3335. 356599700353346/356975820353343. 356599700353353/356975820353350. 356599700353361/356975820353368. 356599700353379/35697582
0353376. 356599700353387/356975820353384. 356599700353403/356975820353400. 356599700353411/356975820353418. 356599700353437/35697
5820353434. 356599700353445/356975820353442.356599700353452/356975820353459. 356599700353478/356975820353475. 356599700353494/356
975820353491. 356599700353502/356975820353509. 356599700353569/356975820353566. 356599700353585/356975820353582. 356599700353593/
356975820353590. 356599700353601/356975820353608. 356599700353635/356975820353632. 356599700353809/356975820353806. 3565997003538
66/356975820353863. 356599700353932/356975820353939. 356599700353957/356975820353954. 356599700354005/356975820354002. 3565997003
54112/356975820354119. 356599700354146/356975820354143. 356599700354195/356975820354192.356599700354328/356975820354325. 35659970
0354369/356975820354366. 356599700354419/356975820354416. 356599700354435/356975820354432. 356599700354476/356975820354473. 35659
9700354526/356975820354523. 356599700354534/356975820354531. 356599700354567/356975820354564. 356599700354575/356975820354572. 35
6599700354583/356975820354580. 356599700354617/356975820354614. 356599700354625/356975820354622. 356599700354641/356975820354648.
356599700354674/356975820354671. 356599700354690/356975820354697. 356599700354708/356975820354705. 356599700354716/3569758203547
13. 356599700354724/356975820354721. 356599700354773/356975820354770. 356599700354799/356975820354796. 356599700354807/3569758203
54804. 356599700354823/356975820354820. 356599700354849/356975820354846. 356599700354856/356975820354853. 356599700354864/3569758
20354861. 356599700354872/356975820354879. 356599700354906/356975820354903. 356599700354914/356975820354911. 356599700354922/3569
75820354929. 356599700354955/356975820354952. 356599700354963/356975820354960. 356599700354971/356975820354978. 356599700354997/3
56975820354994. 356599700355044/356975820355041. 356599700355051/356975820355058. 356599700355069/356975820355066. 35659970035508
5/356975820355082. 356599700355093/356975820355090. 356599700355101/356975820355108. 356599700355127/356975820355124. 35659970035
5135/356975820355132. 356599700355150/356975820355157. 356599700355168/356975820355165. 356599700355234/356975820355231. 35659970
0355242/356975820355249. 356599700355275/356975820355272. 356599700355283/356975820355280. 356599700355291/356975820355298. 35659
9700355317/356975820355314. 356599700355325/356975820355322. 356599700355341/356975820355348. 356599700355358/356975820355355. 35
6599700355374/356975820355371.356599700355382/356975820355389. 356599700355390/356975820355397. 356599700355408/356975820355405.
356599700355457/356975820355454. 356599700355465/356975820355462. 356599700355523/356975820355520. 356599700355564/35697582035556
1. 356599700355572/356975820355579. 356599700355580/356975820355587. 356599700355630/356975820355637. 356599700355713/35697582035
032026000381574-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000381574-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
5710. 356599700355721/356975820355728. 356599700355739/356975820355736. 356599700355788/356975820355785. 356599700355804/35697582
0355801. 356599700355812/356975820355819. 356599700355820/356975820355827.356599700355846/356975820355843. 356599700355853/356975
820355850. 356599700355879/356975820355876. 356599700355903/356975820355900. 356599700355911/356975820355918. 356599700355945/356
975820355942. 356599700355952/356975820355959. 356599700355960/356975820355967. 356599700355986/356975820355983. 356599700355994/
356975820355991. 356599700356000/356975820356007. 356599700356018/356975820356015. 356599700356026/356975820356023. 3565997003560
34/356975820356031. 356599700356042/356975820356049. 356599700356059/356975820356056. 356599700356067/356975820356064. 3565997003
56091/356975820356098. 356599700356109/356975820356106. 356599700356125/356975820356122. 356599700356133/356975820356130. 3565997
00356174/356975820356171. 356599700356190/356975820356197. 356599700356208/356975820356205. 356599700356216/356975820356213. 3565
99700356224/356975820356221. 356599700356232/356975820356239. 356599700356240/356975820356247. 356599700356257/356975820356254. 3
56599700356265/356975820356262. 356599700356273/356975820356270. 356599700356281/356975820356288. 356599700356299/356975820356296
. 356599700356331/356975820356338. 356599700356349/356975820356346. 356599700356356/356975820356353. 356599700356364/356975820356
361. 356599700356372/356975820356379. 356599700356380/356975820356387. 356599700356398/356975820356395. 356599700356406/356975820
356403. 356599700356422/356975820356429. 356599700356430/356975820356437. 356599700356463/356975820356460. 356599700356489/356975
820356486. 356599700356497/356975820356494. 356599700356505/356975820356502. 356599700356521/356975820356528. 356599700356604/356
975820356601. 356599700356612/356975820356619. 356599700356620/356975820356627. 356599700356646/356975820356643. 356599700356653/
356975820356650.356599700356661/356975820356668. 356599700356687/356975820356684. 356599700356695/356975820356692. 35659970035671
1/356975820356718. 356599700356729/356975820356726. 356599700356745/356975820356742. 356599700356752/356975820356759. 35659970035
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0356810/356975820356817. 356599700356828/356975820356825. 356599700356836/356975820356833. 356599700356844/356975820356841. 35659
9700356851/356975820356858. 356599700356869/356975820356866.356599700356877/356975820356874. 356599700356885/356975820356882. 356
599700356919/356975820356916. 356599700356943/356975820356940. 356599700356950/356975820356957. 356599700356968/356975820356965.
356599700356976/356975820356973. 356599700356984/356975820356981. 356599700357008/356975820357005. 356599700357016/35697582035701
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032026000381574-1
Espacio para uso exclusivo de la Entidad Recaudadora
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