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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
032026000379056-1
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
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. SHAN0471997
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
9104195500
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.
196.50
72 . Peso neto kgs. dcms.
148.40
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
530.00
78 .Valor FOB
USD
119.276.67
79 . Valor fletes USD
1.597.55 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
455.461.843
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
455.461.843
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
3.99
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.601.54
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
120.878.21
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: 593706-DECL: 2009660-DO: 893105822261- 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: 3110582237. ID DELIVERY: 6087482139. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A376BDGKLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A37 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE OS(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
032026000379056
133. Feha: 202603 11
134 . Levante No. 032026000369090 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 92032606187815
Fecha presentación 2026-03-11 15:18:32
Valor pagado $0.00
Fecha de Impresión: 2026-03-16 14:46:08
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000379056-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
CURO,MODELO: SM-A376B/DS,USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A376B/DS,DARK GREEN,LTC( QTY. 530,00 u )(5
30,00 PCE ); IMEIS: 356599700248280/356975820248287. 356599700248298/356975820248295. 356599700248322/356975820248329. 3565997002
48504/356975820248501. 356599700248884/356975820248881. 356599700248892/356975820248899. 356599700248918/356975820248915. 3565997
00248926/356975820248923. 356599700248942/356975820248949. 356599700248959/356975820248956. 356599700248975/356975820248972. 3565
99700248983/356975820248980. 356599700248991/356975820248998. 356599700249015/356975820249012. 356599700249031/356975820249038. 3
56599700249064/356975820249061. 356599700249155/356975820249152. 356599700249239/356975820249236. 356599700249379/356975820249376
. 356599700249395/356975820249392. 356599700249403/356975820249400. 356599700249429/356975820249426. 356599700249437/356975820249
434. 356599700249445/356975820249442. 356599700249452/356975820249459. 356599700249478/35697 5820249475. 356599700249510/35697582
0249517. 356599700249668/356975820249665. 356599700249676/356975820249673. 356599700250187/356975820250184. 356599700250195/35697
5820250192. 356599700250278/356975820250275.356599700250294/356975820250291. 356599700250302/356975820250309. 356599700250310/356
975820250317. 356599700250336/356975820250333. 356599700250344/356975820250341. 356599700250351/356975820250358. 356599700250369/
356975820250366. 356599700250419/356975820250416. 356599700250724/356975820250721. 356599700250740/356975820250747. 3565997002507
73/356975820250770. 356599700250799/356975820250796. 356599700250856/356975820250853. 356599700250872/356975820250879. 3565997002
50898/356975820250895. 356599700250914/356975820250911. 356599700250948/356975820250945.356599700250955/356975820250952. 35659970
0250963/356975820250960. 356599700251052/356975820251059. 356599700251060/356975820251067. 356599700251102/356975820251109. 35659
9700251144/356975820251141. 356599700251151/356975820251158. 356599700251177/356975820251174. 356599700251185/356975820251182. 35
6599700251193/356975820251190. 356599700251201/356975820251208. 356599700251227/356975820251224. 356599700251235/356975820251232.
356599700251243/356975820251240. 356599700251276/356975820251273. 356599700251284/356975820251281. 356599700251292/3569758202512
99. 356599700251300/356975820251307. 356599700251318/356975820251315. 356599700251326/356975820251323. 356599700251334/3569758202
51331. 356599700251342/356975820251349. 356599700251359/356975820251356. 356599700251367/356975820251364. 356599700251375/3569758
20251372. 356599700251383/356975820251380. 356599700251391/356975820251398. 356599700251409/356975820251406. 356599700251417/3569
75820251414. 356599700251425/356975820251422. 356599700251433/356975820251430. 356599700251441/356975820251448. 356599700251458/3
56975820251455. 356599700251466/356975820251463. 356599700251474/356975820251471. 356599700251482/356975820251489. 35659970025149
0/356975820251497. 356599700251508/356975820251505. 356599700251516/356975820251513. 356599700251524/356975820251521. 35659970025
1532/356975820251539. 356599700251540/356975820251547. 356599700251557/356975820251554. 356599700251565/356975820251562. 35659970
0251573/356975820251570. 356599700251581/356975820251588. 356599700251599/356975820251596. 356599700251615/356975820251612. 35659
9700251623/356975820251620. 356599700251631/356975820251638. 356599700251649/356975820251646. 356599700251656/356975820251653. 35
6599700251664/356975820251661.356599700251672/356975820251679. 356599700251680/356975820251687. 356599700251698/356975820251695.
356599700251706/356975820251703. 356599700251714/356975820251711. 356599700251722/356975820251729. 356599700251730/35697582025173
7. 356599700251748/356975820251745. 356599700251755/356975820251752. 356599700251763/356975820251760. 356599700251771/35697582025
1778. 356599700251789/356975820251786. 356599700251797/356975820251794. 356599700251805/356975820251802. 356599700251813/35697582
0251810. 356599700251821/356975820251828. 356599700251839/356975820251836.356599700251847/356975820251844. 356599700251854/356975
820251851. 356599700251862/356975820251869. 356599700251870/356975820251877. 356599700251888/356975820251885. 356599700251896/356
975820251893. 356599700251904/356975820251901. 356599700251912/356975820251919. 356599700251920/356975820251927. 356599700251938/
356975820251935. 356599700251946/356975820251943. 356599700251953/356975820251950. 356599700251961/356975820251968. 3565997002526
70/356975820252677. 356599700252720/356975820252727. 356599700254304/356975820254301. 356599700256085/356975820256082. 3565997002
56119/356975820256116. 356599700256127/356975820256124. 356599700256192/356975820256199. 356599700256200/356975820256207. 3565997
00256218/356975820256215. 356599700256226/356975820256223. 356599700256234/356975820256231. 356599700256242/356975820256249. 3565
99700256259/356975820256256. 356599700256267/356975820256264. 356599700256275/356975820256272. 356599700256325/356975820256322. 3
56599700256333/356975820256330. 356599700256382/356975820256389. 356599700256390/356975820256397. 356599700256408/356975820256405
. 356599700256416/356975820256413. 356599700256424/356975820256421. 356599700256440/356975820256447. 356599700256457/356975820256
454. 356599700256465/356975820256462. 356599700256473/356975820256470. 356599700256481/356975820256488. 356599700256499/356975820
256496. 356599700256507/356975820256504. 356599700256515/356975820256512. 356599700256523/356975820256520. 356599700256531/356975
820256538. 356599700256549/356975820256546. 356599700256556/356975820256553. 356599700256564/356975820256561. 356599700256572/356
975820256579. 356599700256580/356975820256587. 356599700256598/356975820256595. 356599700256622/356975820256629. 356599700256630/
356975820256637.356599700256648/356975820256645. 356599700256655/356975820256652. 356599700256689/356975820256686. 35659970025669
7/356975820256694. 356599700256747/356975820256744. 356599700256754/356975820256751. 356599700256812/356975820256819. 35659970025
6820/356975820256827. 356599700256861/356975820256868. 356599700256879/356975820256876. 356599700256887/356975820256884. 35659970
0256911/356975820256918. 356599700256929/356975820256926. 356599700256986/356975820256983. 356599700256994/356975820256991. 35659
9700257000/356975820257007. 356599700257018/356975820257015.356599700257026/356975820257023. 356599700257034/356975820257031. 356
599700257042/356975820257049. 356599700257059/356975820257056. 356599700257075/356975820257072. 356599700257083/356975820257080.
356599700257091/356975820257098. 356599700257109/356975820257106. 356599700257117/356975820257114. 356599700257133/35697582025713
0. 356599700257141/356975820257148. 356599700257158/356975820257155. 356599700257166/356975820257163. 356599700257182/35697582025
7189. 356599700257190/356975820257197. 356599700257208/356975820257205. 356599700257216/356975820257213. 356599700257224/35697582
0257221. 356599700257232/356975820257239. 356599700257240/356975820257247. 356599700257257/356975820257254. 356599700257265/35697
5820257262. 356599700257273/356975820257270. 356599700257281/356975820257288. 356599700257299/356975820257296. 356599700257307/35
6975820257304. 356599700257323/356975820257320. 356599700257331/356975820257338. 356599700257349/356975820257346. 356599700257356
/356975820257353. 356599700257364/356975820257361. 356599700257372/356975820257379. 356599700257380/356975820257387. 356599700257
398/356975820257395. 356599700257406/356975820257403. 356599700257422/356975820257429. 356599700257448/356975820257445. 356599700
257463/356975820257460. 356599700257471/356975820257478. 356599700257489/356975820257486. 356599700257505/356975820257502. 356599
700257513/356975820257510. 356599700257521/356975820257528. 356599700257539/356975820257536. 356599700257547/356975820257544. 356
599700257554/356975820257551. 356599700257562/356975820257569. 356599700257570/356975820257577. 356599700257596/356975820257593.
356599700257604/356975820257601. 356599700257612/356975820257619. 356599700257620/356975820257627. 356599700257638/35697582025763
5.356599700257646/356975820257643. 356599700257653/356975820257650. 356599700257679/356975820257676. 356599700257687/356975820257
684. 356599700257703/356975820257700. 356599700257711/356975820257718. 356599700257729/356975820257726. 356599700257737/356975820
257734. 356599700257745/356975820257742. 356599700257752/356975820257759. 356599700257760/356975820257767. 356599700257778/356975
820257775. 356599700257786/356975820257783. 356599700257794/356975820257791. 356599700257802/356975820257809. 356599700257810/356
975820257817. 356599700257828/356975820257825.356599700257836/356975820257833. 356599700257844/356975820257841. 356599700257869/3
56975820257866. 356599700257893/356975820257890. 356599700257901/356975820257908. 356599700257919/356975820257916. 35659970025792
7/356975820257924. 356599700257943/356975820257940. 356599700257950/356975820257957. 356599700257968/356975820257965. 35659970025
7976/356975820257973. 356599700257984/356975820257981. 356599700257992/356975820257999. 356599700258008/356975820258005. 35659970
0258016/356975820258013. 356599700258024/356975820258021. 356599700258032/356975820258039. 356599700258040/356975820258047. 35659
9700258057/356975820258054. 356599700258065/356975820258062. 356599700258081/356975820258088. 356599700258099/356975820258096. 35
6599700258107/356975820258104. 356599700258115/356975820258112. 356599700258123/356975820258120. 356599700258131/356975820258138.
356599700258149/356975820258146. 356599700258156/356975820258153. 356599700258164/356975820258161. 356599700258172/3569758202581
032026000379056-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000379056-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
79. 356599700258180/356975820258187. 356599700258198/356975820258195. 356599700258206/356975820258203. 356599700258214/3569758202
58211. 356599700258248/356975820258245. 356599700258255/356975820258252. 356599700258263/356975820258260. 356599700258271/3569758
20258278. 356599700258388/356975820258385. 356599700258396/356975820258393. 356599700258438/356975820258435. 356599700258446/3569
75820258443. 356599700258453/356975820258450. 356599700258461/356975820258468. 356599700258479/356975820258476. 356599700258487/3
56975820258484. 356599700258495/356975820258492. 356599700258503/356975820258500. 356599700258511/356975820258518. 35659970025852
9/356975820258526. 356599700258537/356975820258534. 356599700258545/356975820258542. 356599700258552/356975820258559.356599700258
560/356975820258567. 356599700258578/356975820258575. 356599700258586/356975820258583. 356599700258594/356975820258591. 356599700
258610/356975820258617. 356599700258628/356975820258625. 356599700258636/356975820258633. 356599700258644/356975820258641. 356599
700258651/356975820258658. 356599700258669/356975820258666. 356599700258677/356975820258674. 356599700258685/356975820258682. 356
599700258693/356975820258690. 356599700258719/356975820258716. 356599700258735/356975820258732. 356599700258743/356975820258740.
356599700258776/356975820258773.356599700258784/356975820258781. 356599700258792/356975820258799. 356599700258826/356975820258823
. 356599700258842/356975820258849. 356599700258859/356975820258856. 356599700258875/356975820258872. 356599700258883/356975820258
880. 356599700258891/356975820258898. 356599700258909/356975820258906. 356599700258925/356975820258922. 356599700258933/356975820
258930. 356599700258966/356975820258963. 356599700258974/356975820258971. 356599700258982/356975820258989. 356599700259014/356975
820259011. 356599700259022/356975820259029. 356599700259048/356975820259045. 356599700259063/356975820259060. 356599700259147/356
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599. 356599700259600/356975820259607. 356599700259618/356975820259615. 356599700259659/356975820259656.356599700259667/3569758202
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1/356975820259938.356599700259949/356975820259946. 356599700259998/356975820259995. 356599700260004/356975820260001. 356599700260
020/356975820260027. 356599700260038/356975820260035. 356599700260053/356975820260050. 356599700260061/356975820260068. 356599700
260079/356975820260076. 356599700260103/356975820260100. 356599700260111/356975820260118. 356599700260137/356975820260134. 356599
700260145/356975820260142. 356599700260178/356975820260175. 356599700260186/356975820260183. 356599700260194/356975820260191. 356
599700260202/356975820260209. 356599700260210/356975820260217. 356599700260228/356975820260225. 356599700260236/356975820260233.
356599700260244/356975820260241. 356599700260251/356975820260258. 356599700260269/356975820260266. 356599700260277/35697582026027
4. 356599700260285/356975820260282. 356599700260301/356975820260308. 356599700260319/356975820260316. 356599700260327/35697582026
0324. 356599700260335/356975820260332. 356599700260343/356975820260340. 356599700260350/356975820260357. 356599700260368/35697582
0260365. 356599700260376/356975820260373. 356599700260384/356975820260381. 356599700260392/356975820260399. 356599700260400/35697
5820260407. 356599700260418/356975820260415. 356599700260426/356975820260423. 356599700260434/356975820260431. 356599700260442/35
6975820260449. 356599700260459/356975820260456. 356599700260475/356975820260472. 356599700260491/356975820260498. 356599700261226
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261325/356975820261322. 356599700261333/356975820261330. 356599700261358/356975820261355.356599700261366/356975820261363. 3565997
00261382/356975820261389. 356599700261408/356975820261405. 356599700261416/356975820261413. 356599700261424/356975820261421. 3565
99700261432/356975820261439. 356599700261440/356975820261447. 356599700261457/356975820261454. 356599700261465/356975820261462. 3
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587.356599700261598/356975820261595. 356599700261671/356975820261678. 356599700261689/356975820261686. 356599700261739/3569758202
61736. 356599700261747/356975820261744. 356599700261754/356975820261751. 356599700261762/356975820261769. 356599700261770/3569758
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75820261835. 356599700261846/356975820261843. 356599700261853/356975820261850. 356599700261895/356975820261892. 356599700261903/3
56975820261900. 356599700261929/356975820261926. 356599700261937/356975820261934. 356599700261945/356975820261942. 35659970026197
8/356975820261975. 356599700261986/356975820261983. 356599700261994/356975820261991. 356599700262000/356975820262007. 35659970026
2018/356975820262015. 356599700262083/356975820262080. 356599700262117/356975820262114. 356599700262240/356975820262247. 35659970
0262323/356975820262320. 356599700262448/356975820262445. 356599700262489/356975820262486. 356599700262513/356975820262510. 35659
9700262521/356975820262528. 356599700267793/356975820267790. 356599700270227/356975820270224. 356599700274047/356975820274044. 35
6599700274674/356975820274671. 356599700275150/356975820275157. 356599700279764/356975820279761. 356599700280218/356975820280215.
356599700357040/356975820357047. 356599700357131/356975820357138. 356599700357198/356975820357195. 356599700357206/3569758203572
03. 356599700357271/356975820357278. 356599700357289/356975820357286. 356599700357297/356975820357294. 356599700357354/3569758203
57351. 356599700357362/356975820357369. 356599700357388/356975820357385. 356599700357404/356975820357401. 356599700357446/3569758
20357443. 356599700357461/356975820357468. 356599700357479/356975820357476.356599700357495/356975820357492. 356599700357529/35697
5820357526. 356599700357537/356975820357534. 356599700357610/356975820357617. 356599700357636/356975820357633. 356599700439004/35
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032026000379056-1
Espacio para uso exclusivo de la Entidad Recaudadora
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