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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
032026000378486-9
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. 116575016799130
43 . Año – Mes – Día
2026 – 03 – 14
44 . Documento de transporte
No. SHAN0471994
45 . Año – Mes – Día
2026 – 03 – 07
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
9104194997
52 . Año – Mes – Día
2026 – 03 – 07
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.
186.50
72 . Peso neto kgs. dcms.
140.00
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
112.516.04
79 . Valor fletes USD
1.516.25 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
429.680.994
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
429.680.994
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
3.76
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.520.01
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
114.036.05
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: 593687-DECL: 2009624-DO: 893105819261- 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: 3110499872. ID DELIVERY: 6087482138. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A376BZAKLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A37 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: GRIS,MOD(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
032026000378486
133. Feha: 202603 11
134 . Levante No. 032026000368637 135 . Fecha
2026 – 03 – 16
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 92032606185453
Fecha presentación 2026-03-11 14:02:56
Valor pagado $0.00
Fecha de Impresión: 2026-03-16 14:21:15
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000378486-9
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ELO: SM-A376B/DS,USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A376B/DS,GRAY,LTC( QTY. 500,00 u )(500,00 PCE ); I
MEIS: 356599700359400/356975820359407. 356599700359582/356975820359589. 356599700359608/356975820359605. 356599700359616/35697582
0359613. 356599700359699/356975820359696. 356599700359715/356975820359712. 356599700359764/356975820359761.356599700360069/356975
820360066. 356599700360192/356975820360199. 356599700360358/356975820360355. 356599700360887/356975820360884. 356599700361059/356
975820361056. 356599700361067/356975820361064. 356599700361158/356975820361155. 356599700361174/356975820361171. 356599700361240/
356975820361247. 356599700361257/356975820361254. 356599700361265/356975820361262. 356599700361273/356975820361270. 3565997003613
15/356975820361312. 356599700361331/356975820361338. 356599700361356/356975820361353. 356599700361364/356975820361361. 3565997003
61414/356975820361411. 356599700361422/356975820361429. 356599700366348/356975820366345. 35 6599700366470/356975820366477. 356599
700366512/356975820366519. 356599700367148/356975820367145. 356599700367189/356975820367186. 356599700367205/356975820367202. 356
599700367239/356975820367236. 356599700367296/356975820367293. 356599700367361/356975820367368. 356599700367510/356975820367517.
356599700367635/356975820367632. 356599700367734/356975820367731. 356599700367742/356975820367749. 356599700367866/35697582036786
3. 356599700367882/356975820367889. 356599700367908/356975820367905. 356599700367916/356975820367913. 356599700367924/35697582036
7921. 356599700367932/356975820367939. 356599700367957/356975820367954. 356599700367981/356975820367988. 356599700367999/35697582
0367996. 356599700368260/356975820368267. 356599700368823/356975820368820. 356599700368914/356975820368911. 356599700368997/35697
5820368994. 356599700369003/356975820369000. 356599700369318/356975820369315. 356599700369334/356975820369331. 356599700369524/35
6975820369521. 356599700369532/356975820369539. 356599700369540/356975820369547. 356599700369557/356975820369554. 356599700369573
/356975820369570. 356599700369581/356975820369588.356599700369599/356975820369596. 356599700369607/356975820369604. 3565997003696
15/356975820369612. 356599700369631/356975820369638. 356599700369656/356975820369653. 356599700369698/356975820369695. 3565997003
69730/356975820369737. 356599700369789/356975820369786. 356599700369953/356975820369950. 356599700370019/356975820370016. 3565997
00370027/356975820370024. 356599700370084/356975820370081. 356599700370159/356975820370156. 356599700370175/356975820370172. 3565
99700370183/356975820370180. 356599700370217/356975820370214. 356599700370225/356975820370222.356599700370258/356975820370255. 35
6599700370266/356975820370263. 356599700370324/356975820370321. 356599700370332/356975820370339. 356599700370340/356975820370347.
356599700370357/356975820370354. 356599700370365/356975820370362. 356599700370373/356975820370370. 356599700370381/3569758203703
88. 356599700370399/356975820370396. 356599700370407/356975820370404. 356599700370464/356975820370461. 356599700370746/3569758203
70743. 356599700370852/356975820370859. 356599700370886/356975820370883. 356599700370894/356975820370891. 356599700371041/3569758
20371048. 356599700371090/356975820371097. 356599700371116/356975820371113. 356599700371140/356975820371147. 356599700371223/3569
75820371220. 356599700371231/356975820371238. 356599700371314/356975820371311. 356599700371330/356975820371337. 356599700371363/3
56975820371360. 356599700371413/356975820371410. 356599700371447/356975820371444. 356599700371504/356975820371501. 35659970037155
3/356975820371550. 356599700371561/356975820371568. 356599700371629/356975820371626. 356599700371959/356975820371956. 35659970037
2015/356975820372012. 356599700372064/356975820372061. 356599700372346/356975820372343. 356599700372981/356975820372988. 35659970
0373047/356975820373044. 356599700373054/356975820373051. 356599700373088/356975820373085. 356599700373096/356975820373093. 35659
9700373112/356975820373119. 356599700373146/356975820373143. 356599700373187/356975820373184. 356599700373211/356975820373218. 35
6599700373245/356975820373242. 356599700373286/356975820373283. 356599700373310/356975820373317. 356599700373328/356975820373325.
356599700373385/356975820373382. 356599700373393/356975820373390. 356599700373419/356975820373416. 356599700373443/3569758203734
40. 356599700373450/356975820373457.356599700373468/356975820373465. 356599700373476/356975820373473. 356599700373559/35697582037
3556. 356599700374011/356975820374018. 356599700374102/356975820374109. 356599700374110/356975820374117. 356599700374136/35697582
0374133. 356599700374144/356975820374141. 356599700374177/356975820374174. 356599700374193/356975820374190. 356599700374219/35697
5820374216. 356599700376347/356975820376344. 356599700381420/356975820381427. 356599700381438/356975820381435. 356599700381446/35
6975820381443. 356599700381479/356975820381476. 356599700381487/356975820381484.356599700381495/356975820381492. 356599700381503/
356975820381500. 356599700381537/356975820381534. 356599700381545/356975820381542. 356599700381552/356975820381559. 3565997003815
60/356975820381567. 356599700381578/356975820381575. 356599700381586/356975820381583. 356599700381594/356975820381591. 3565997003
81602/356975820381609. 356599700381610/356975820381617. 356599700381628/356975820381625. 356599700381677/356975820381674. 3565997
00381685/356975820381682. 356599700381701/356975820381708. 356599700381719/356975820381716. 356599700381727/356975820381724. 3565
99700381735/356975820381732. 356599700381750/356975820381757. 356599700381768/356975820381765. 356599700381776/356975820381773. 3
56599700381784/356975820381781. 356599700381792/356975820381799. 356599700381800/356975820381807. 356599700381818/356975820381815
. 356599700381826/356975820381823. 356599700381834/356975820381831. 356599700381842/356975820381849. 356599700381859/356975820381
856. 356599700381867/356975820381864. 356599700381883/356975820381880. 356599700381891/356975820381898. 356599700381909/356975820
381906. 356599700381917/356975820381914. 356599700381933/356975820381930. 356599700381941/356975820381948. 356599700381958/356975
820381955. 356599700381966/356975820381963. 356599700381974/356975820381971. 356599700381990/356975820381997. 356599700382006/356
975820382003. 356599700382014/356975820382011. 356599700382022/356975820382029. 356599700382030/356975820382037. 356599700382048/
356975820382045. 356599700382063/356975820382060. 356599700382071/356975820382078. 356599700382089/356975820382086. 3565997003820
97/356975820382094. 356599700382105/356975820382102. 356599700382113/356975820382110. 356599700382121/356975820382128. 3565997003
82139/356975820382136.356599700382147/356975820382144. 356599700382154/356975820382151. 356599700382162/356975820382169. 35659970
0382170/356975820382177. 356599700382188/356975820382185. 356599700382196/356975820382193. 356599700382204/356975820382201. 35659
9700382220/356975820382227. 356599700382238/356975820382235. 356599700382246/356975820382243. 356599700382253/356975820382250. 35
6599700382261/356975820382268. 356599700382279/356975820382276. 356599700382287/356975820382284. 356599700382295/356975820382292.
356599700382303/356975820382300. 356599700382311/356975820382318.356599700382337/356975820382334. 356599700382352/35697582038235
9. 356599700382360/356975820382367. 356599700382378/356975820382375. 356599700382386/356975820382383. 356599700382394/35697582038
2391. 356599700382402/356975820382409. 356599700382410/356975820382417. 356599700382428/356975820382425. 356599700382436/35697582
0382433. 356599700382451/356975820382458. 356599700382469/356975820382466. 356599700382477/356975820382474. 356599700382485/35697
5820382482. 356599700382493/356975820382490. 356599700382501/356975820382508. 356599700382519/356975820382516. 356599700382527/35
6975820382524. 356599700382535/356975820382532. 356599700382543/356975820382540. 356599700382550/356975820382557. 356599700382576
/356975820382573. 356599700382584/356975820382581. 356599700382592/356975820382599. 356599700382600/356975820382607. 356599700382
618/356975820382615. 356599700382626/356975820382623. 356599700382634/356975820382631. 356599700382642/356975820382649. 356599700
382667/356975820382664. 356599700382931/356975820382938. 356599700382949/356975820382946. 356599700382972/356975820382979. 356599
700382980/356975820382987. 356599700382998/356975820382995. 356599700383053/356975820383050. 356599700383095/356975820383092. 356
599700383103/356975820383100. 356599700383111/356975820383118. 356599700383145/356975820383142. 356599700383160/356975820383167.
356599700383178/356975820383175. 356599700383186/356975820383183. 356599700383202/356975820383209. 356599700383210/35697582038321
7. 356599700383269/356975820383266. 356599700383277/356975820383274. 356599700383285/356975820383282. 356599700383293/35697582038
3290. 356599700383301/356975820383308. 356599700383319/356975820383316. 356599700383327/356975820383324. 356599700383335/35697582
0383332.356599700383343/356975820383340. 356599700383350/356975820383357. 356599700383376/356975820383373. 356599700383384/356975
820383381. 356599700383392/356975820383399. 356599700383400/356975820383407. 356599700383418/356975820383415. 356599700383426/356
975820383423. 356599700383434/356975820383431. 356599700383442/356975820383449. 356599700383459/356975820383456. 356599700383467/
356975820383464. 356599700383475/356975820383472. 356599700383483/356975820383480. 356599700383491/356975820383498. 3565997003835
09/356975820383506. 356599700383525/356975820383522.356599700383533/356975820383530. 356599700383541/356975820383548. 35659970038
032026000378486-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000378486-9
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
3558/356975820383555. 356599700383566/356975820383563. 356599700383574/356975820383571. 356599700383582/356975820383589. 35659970
0383590/356975820383597. 356599700383608/356975820383605. 356599700383616/356975820383613. 356599700383624/356975820383621. 35659
9700383632/356975820383639. 356599700383640/356975820383647. 356599700383657/356975820383654. 356599700383665/356975820383662. 35
6599700383673/356975820383670. 356599700383681/356975820383688. 356599700383699/356975820383696. 356599700383707/356975820383704.
356599700383715/356975820383712. 356599700383731/356975820383738. 356599700383749/356975820383746. 356599700383756/3569758203837
53. 356599700383764/356975820383761. 356599700383772/356975820383779. 356599700383780/356975820383787. 356599700383798/3569758203
83795. 356599700383806/356975820383803. 356599700383814/356975820383811. 356599700383822/356975820383829. 356599700383830/3569758
20383837. 356599700383848/356975820383845. 356599700383855/356975820383852. 356599700383871/356975820383878. 356599700383889/3569
75820383886. 356599700383913/356975820383910. 356599700383970/356975820383977. 356599700383988/356975820383985. 356599700383996/3
56975820383993. 356599700384002/356975820384009. 356599700384010/356975820384017. 356599700384051/356975820384058. 35659970038407
7/356975820384074. 356599700384085/356975820384082. 356599700384119/356975820384116. 356599700384127/356975820384124. 35659970038
4135/356975820384132. 356599700384150/356975820384157. 356599700384168/356975820384165. 356599700384176/356975820384173. 35659970
0384184/356975820384181. 356599700384192/356975820384199. 356599700384200/356975820384207. 356599700384226/356975820384223.356599
700384267/356975820384264. 356599700384275/356975820384272. 356599700384283/356975820384280. 356599700384317/356975820384314. 356
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356599700384895/356975820384892. 356599700384903/356975820384900. 356599700384937/356975820384934. 356599700384960/35697582038496
7. 356599700384986/356975820384983. 356599700385538/356975820385535. 356599700385603/356975820385600. 356599700385785/35697582038
5782. 356599700386254/356975820386251.356599700386304/356975820386301. 356599700386312/356975820386319. 356599700386395/356975820
386392. 356599700386544/356975820386541. 356599700386692/356975820386699. 356599700386726/356975820386723. 356599700386783/356975
820386780. 356599700386841/356975820386848. 356599700386965/356975820386962. 356599700387237/356975820387234. 356599700387278/356
975820387275. 356599700387286/356975820387283. 356599700387310/356975820387317. 356599700387682/356975820387689. 356599700387757/
356975820387754. 356599700387799/356975820387796. 356599700387849/356975820387846. 356599700387898/356975820387895. 3565997003879
22/356975820387929. 356599700387930/356975820387937. 356599700387948/356975820387945. 356599700387955/356975820387952. 3565997003
87989/356975820387986. 356599700387997/356975820387994. 356599700388011/356975820388018. 356599700388045/356975820388042. 3565997
00388052/356975820388059. 356599700388060/356975820388067. 356599700388110/356975820388117. 356599700388128/356975820388125. 3565
99700388144/356975820388141. 356599700388151/356975820388158. 356599700388169/356975820388166. 356599700388185/356975820388182. 3
56599700388193/356975820388190. 356599700388201/356975820388208. 356599700388219/356975820388216. 356599700388227/356975820388224
. 356599700388235/356975820388232. 356599700388243/356975820388240. 356599700388250/356975820388257. 356599700388268/356975820388
265. 356599700388276/356975820388273. 356599700388284/356975820388281. 356599700388292/356975820388299. 356599700388300/356975820
388307. 356599700388318/356975820388315. 356599700388326/356975820388323. 356599700388334/356975820388331. 356599700388342/356975
820388349. 356599700388359/356975820388356. 356599700388367/356975820388364. 356599700388375/356975820388372.356599700388383/3569
75820388380. 356599700388391/356975820388398. 356599700388409/356975820388406. 356599700388425/356975820388422. 356599700388433/3
56975820388430. 356599700388441/356975820388448. 356599700388466/356975820388463. 356599700388474/356975820388471. 35659970038848
2/356975820388489. 356599700388490/356975820388497. 356599700388508/356975820388505. 356599700388516/356975820388513. 35659970038
8532/356975820388539. 356599700388540/356975820388547. 356599700388557/356975820388554. 356599700388565/356975820388562. 35659970
0388573/356975820388570.356599700388599/356975820388596. 356599700388631/356975820388638. 356599700388672/356975820388679. 356599
700388698/356975820388695. 356599700388706/356975820388703. 356599700388714/356975820388711. 356599700389167/356975820389164. 356
599700389266/356975820389263. 356599700389399/356975820389396. 356599700389407/356975820389404. 356599700389415/356975820389412.
356599700389423/356975820389420. 356599700389431/356975820389438. 356599700389449/356975820389446. 356599700389464/35697582038946
1. 356599700389472/356975820389479. 356599700389480/356975820389487. 356599700389498/356975820389495. 356599700389506/35697582038
9503. 356599700389514/356975820389511. 356599700389522/356975820389529. 356599700389530/356975820389537. 356599700389548/35697582
0389545. 356599700389555/356975820389552. 356599700389563/356975820389560. 356599700389571/356975820389578. 356599700389662/35697
5820389669. 356599700389902/356975820389909. 356599700390108/356975820390105. 356599700390124/356975820390121. 356599700390249/35
6975820390246. 356599700390256/356975820390253. 356599700390298/356975820390295. 356599700390322/356975820390329. 356599700390389
/356975820390386. 356599700390421/356975820390428. 356599700390439/356975820390436. 356599700390496/356975820390493. 356599700390
553/356975820390550. 356599700390561/356975820390568. 356599700390579/356975820390576. 356599700390611/356975820390618. 356599700
390629/356975820390626. 356599700390637/356975820390634. 356599700390645/356975820390642. 356599700390652/356975820390659. 356599
700390694/356975820390691. 356599700390728/356975820390725. 356599700390736/356975820390733. 356599700390744/356975820390741. 356
599700390751/356975820390758. 356599700390769/356975820390766. 356599700390777/356975820390774.356599700390793/356975820390790. 3
56599700390801/356975820390808. 356599700390850/356975820390857. 356599700390900/356975820390907. 356599700390918/356975820390915
. 356599700390926/356975820390923. 356599700390934/356975820390931. 356599700392872/356975820392879. 356599700393169/356975820393
166. 356599700393219/356975820393216. 356599700393227/356975820393224. 356599700393235/356975820393232. 356599700393243/356975820
393240. 356599700393276/356975820393273. 356599700393334/356975820393331. 356599700393342/356975820393349. 356599700393425/356975
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032026000378486-9
Espacio para uso exclusivo de la Entidad Recaudadora
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