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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
032026000444369-8
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. 116575016834110
43 . Año – Mes – Día
2026 – 03 – 25
44 . Documento de transporte
No. PVG71696648
45 . Año – Mes – Día
2026 – 03 – 17
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
6900420350
52 . Año – Mes – Día
2026 – 03 – 14
53 . Cod. país
procedencia
215
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.
3.692.48
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.
103.00
72 . Peso neto kgs. dcms.
73.50
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
300.00
78 .Valor FOB
USD
17.242.99
79 . Valor fletes USD
771.47 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
66.520.212
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
66.520.212
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
0.59
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
772.06
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
18.015.05
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: 595250-DECL: 2014122-DO: 893106773261- 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
RESOLUCIÓN 5050 DEL 10 DE NOVIEMBRE DE 2016. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOM
OLOGACIÓN) // NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION.SAMSUNG ELECTRONICS COLOMB
IA S.A. OEA COD. OE0001. . PEDIDOS: 3110942430. ID DELIVERY: 6087724565. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A075MZKGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A07 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO,(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
032026000444369
133. Feha: 202603 24
134 . Levante No. 032026000418379 135 . Fecha
2026 – 03 – 26
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 92032606570355
Fecha presentación 2026-03-24 19:50:01
Valor pagado $0.00
Fecha de Impresión: 2026-03-26 13:09:20
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000444369-8
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MODELO: SM-A075M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A075M/DS,BLACK,LTC( QTY. 300,00 u )(300,00 PC
E ); IMEIS: 357113743028094/359728853028093. 357113743028128/359728853028127. 357113743028367/359728853028366. 357113743028375/35
9728853028374. 357113743028508/359728853028507. 357113743028524/359728853028523. 357113743028532/359728853028531. 357113743028557
/359728853028556. 357113743028565/359728853028564. 357113743028573/359728853028572. 357113743028581/359728853028580. 357113743028
607/359728853028606. 357113743028656/359728853028655. 357113743028839/359728853028838. 357113743029001/359728853029000. 357113743
029159/359728853029158. 357113743029209/359728853029208. 357113743029217/359728853029216. 357113743029225/359728853029224. 357113
743029233/359728853029232. 357113743029241/359728853029240. 357113743029258/359728853029257. 357113743029266/359728853029265. 357
113743029274/359728853029273. 357113743029282/359728853029281. 357113743029290/35972885302929 9. 357113743029308/359728853029307.
357113743029316/359728853029315. 357113743029324/359728853029323. 357113743029332/359728853029331. 357113743029340/3597288530293
49. 357113743029357/359728853029356. 357113743029373/359728853029372. 357113743029381/359728853029380. 357113743029399/3597288530
29398. 357113743029407/359728853029406. 357113743029415/359728853029414. 357113743029423/359728853029422. 357113743029431/3597288
53029430. 357113743029449/359728853029448. 357113743029464/359728853029463. 357113743029472/359728853029471. 357113743029498/3597
28853029497. 357113743029514/359728853029513. 357113743029522/359728853029521.357113743029530/359728853029539. 357113743029548/35
9728853029547. 357113743029555/359728853029554. 357113743029563/359728853029562. 357113743029571/359728853029570. 357113743029589
/359728853029588. 357113743029597/359728853029596. 357113743029605/359728853029604. 357113743029613/359728853029612. 357113743029
621/359728853029620. 357113743029639/359728853029638. 357113743029647/359728853029646. 357113743029654/359728853029653. 357113743
029670/359728853029679. 357113743029688/359728853029687. 357113743029696/359728853029695. 357113743029704/359728853029703.3571137
43029720/359728853029729. 357113743029738/359728853029737. 357113743029746/359728853029745. 357113743029761/359728853029760. 3571
13743029779/359728853029778. 357113743029787/359728853029786. 357113743029795/359728853029794. 357113743029803/359728853029802. 3
57113743029811/359728853029810. 357113743029829/359728853029828. 357113743029845/359728853029844. 357113743029878/359728853029877
. 357113743029886/359728853029885. 357113743029910/359728853029919. 357113743029928/359728853029927. 357113743029936/359728853029
935. 357113743029944/359728853029943. 357113743029951/359728853029950. 357113743029977/359728853029976. 357113743029985/359728853
029984. 357113743029993/359728853029992. 357113743030009/359728853030008. 357113743030017/359728853030016. 357113743030041/359728
853030040. 357113743030058/359728853030057. 357113743030066/359728853030065. 357113743030090/359728853030099. 357113743030124/359
728853030123. 357113743030132/359728853030131. 357113743030173/359728853030172. 357113743030181/359728853030180. 357113743030207/
359728853030206. 357113743030215/359728853030214. 357113743030231/359728853030230. 357113743030264/359728853030263. 3571137430302
72/359728853030271. 357113743030322/359728853030321. 357113743030330/359728853030339. 357113743030355/359728853030354. 3571137430
30397/359728853030396. 357113743030405/359728853030404. 357113743030413/359728853030412. 357113743030421/359728853030420. 3571137
43030439/359728853030438. 357113743030470/359728853030479. 357113743030496/359728853030495. 357113743030553/359728853030552. 3571
13743030561/359728853030560. 357113743030587/359728853030586. 357113743030595/359728853030594. 357113743030629/359728853030628. 3
57113743030637/359728853030636. 357113743030645/359728853030644.357113743030652/359728853030651. 357113743030678/359728853030677.
357113743030686/359728853030685. 357113743030694/359728853030693. 357113743030702/359728853030701. 357113743030728/3597288530307
27. 357113743030736/359728853030735. 357113743030744/359728853030743. 357113743030751/359728853030750. 357113743030769/3597288530
30768. 357113743030785/359728853030784. 357113743030801/359728853030800. 357113743030819/359728853030818. 357113743030827/3597288
53030826. 357113743030835/359728853030834. 357113743030850/359728853030859. 357113743030868/359728853030867.357113743030876/35972
8853030875. 357113743030892/359728853030891. 357113743030900/359728853030909. 357113743030926/359728853030925. 357113743030934/35
9728853030933. 357113743030942/359728853030941. 357113743030959/359728853030958. 357113743030967/359728853030966. 357113743031007
/359728853031006. 357113743031031/359728853031030. 357113743031049/359728853031048. 357113743031056/359728853031055. 357113743031
064/359728853031063. 357113743031072/359728853031071. 357113743031080/359728853031089. 357113743031098/359728853031097. 357113743
031114/359728853031113. 357113743031122/359728853031121. 357113743031155/359728853031154. 357113743031163/359728853031162. 357113
743031189/359728853031188. 357113743031197/359728853031196. 357113743031205/359728853031204. 357113743031213/359728853031212. 357
113743031221/359728853031220. 357113743031239/359728853031238. 357113743031247/359728853031246. 357113743031254/359728853031253.
357113743031270/359728853031279. 357113743031288/359728853031287. 357113743031304/359728853031303. 357113743031353/35972885303135
2. 357113743031379/359728853031378. 357113743031387/359728853031386. 357113743031395/359728853031394. 357113743031411/35972885303
1410. 357113743031452/359728853031451. 357113743031460/359728853031469. 357113743031486/359728853031485. 357113743031528/35972885
3031527. 357113743031536/359728853031535. 357113743031551/359728853031550. 357113743031619/359728853031618. 357113743031635/35972
8853031634. 357113743031643/359728853031642. 357113743031650/359728853031659. 357113743031676/359728853031675. 357113743031692/35
9728853031691. 357113743031742/359728853031741. 357113743031767/359728853031766. 357113743031775/359728853031774. 357113743031791
/359728853031790. 357113743031825/359728853031824.357113743031833/359728853031832. 357113743031841/359728853031840. 3571137430318
58/359728853031857. 357113743031866/359728853031865. 357113743031874/359728853031873. 357113743031882/359728853031881. 3571137430
31890/359728853031899. 357113743031908/359728853031907. 357113743031916/359728853031915. 357113743031924/359728853031923. 3571137
43031932/359728853031931. 357113743031940/359728853031949. 357113743031957/359728853031956. 357113743031973/359728853031972. 3571
13743031981/359728853031980. 357113743031999/359728853031998. 357113743032005/359728853032004.357113743032021/359728853032020. 35
7113743032039/359728853032038. 357113743032070/359728853032079. 357113743032096/359728853032095. 357113743032104/359728853032103.
357113743032146/359728853032145. 357113743032187/359728853032186. 357113743032211/359728853032210. 357113743032229/3597288530322
28. 357113743032237/359728853032236. 357113743032252/359728853032251. 357113743032278/359728853032277. 357113743032302/3597288530
32301. 357113743032328/359728853032327. 357113743032369/359728853032368. 357113743032377/359728853032376. 357113743032385/3597288
53032384. 357113743032427/359728853032426. 357113743032468/359728853032467. 357113743032559/359728853032558. 357113743032567/3597
28853032566. 357113743032575/359728853032574. 357113743032609/359728853032608. 357113743032625/359728853032624. 357113743032633/3
59728853032632. 357113743032666/359728853032665. 357113743032682/359728853032681. 357113743032690/359728853032699. 35711374303271
6/359728853032715. 357113743032724/359728853032723. 357113743032757/359728853032756. 357113743032799/359728853032798. 35711374303
2807/359728853032806. 357113743032831/359728853032830. 357113743032849/359728853032848. 357113743032856/359728853032855. 35711374
3032864/359728853032863. 357113743032872/359728853032871. 357113743032880/359728853032889. 357113743032914/359728853032913. 35711
3743032922/359728853032921. 357113743032948/359728853032947. 357113743032955/359728853032954. 357113743032971/359728853032970. 35
7113743032989/359728853032988. 357113743032997/359728853032996. 357113743033003/359728853033002. 357113743033029/359728853033028.
357113743033037/359728853033036. 357113743033110/359728853033119. 357113743033128/359728853033127. 357113743033136/3597288530331
35. 357113743033144/359728853033143.357113743033177/359728853033176. 357113743033201/359728853033200. 357113743033227/35972885303
3226. 357113743033250/359728853033259. 357113743033318/359728853033317. 357113743033383/359728853033382. 357113743033391/35972885
3033390. 357113743033409/359728853033408. 357113743033466/359728853033465. 357113743033490/359728853033499. 357113743033599/35972
8853033598. 357113743033607/359728853033606. 357113743033623/359728853033622. 357113743033664/359728853033663. 357113743033672/35
9728853033671. 357113743033680/359728853033689. 357113743033698/359728853033697.357113743033714/359728853033713. 357113743033722/
359728853033721. 357113743033730/359728853033739. 357113743033755/359728853033754. 357113743033771/359728853033770. 3571137430337
89/359728853033788. 357113743033797/359728853033796. 357113743033805/359728853033804. 357113743033813/359728853033812. 3571137430
33821/359728853033820. 357113743033839/359728853033838. 357113743033854/359728853033853. 357113743033862/359728853033861. 3571137
43033870/359728853033879. 357113743033888/359728853033887. 357113743033896/359728853033895. 357113743033920/359728853033929. 3571
032026000444369-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000444369-8
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
13743033938/359728853033937. 357113743033946/359728853033945. 357113743033961/359728853033960. 357113743033979/359728853033978. 3
57113743034001/359728853034000. 357113743034019/359728853034018. 357113743034035/359728853034034. 357113743034050/359728853034059
. 357113743034076/359728853034075. 357113743034092/359728853034091. 357113743034100/359728853034109XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032026000444369-8
Espacio para uso exclusivo de la Entidad Recaudadora
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