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REPÚBLICA DE COLOMBIA
Declaración de Importación
Privada
500
1. Año 2024
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032024000214662-3
5 . Número de Identificación Tributaria (NIT)
830028931 13 . Dirección
CR 7 113 43 OF 607
6 . DV. 5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
15 . Teléfono 12 . Cód. Admón. 16 . Cód. Dpto 17 . Cód. Ciudad Municipio
4870707 03 11 001
24 . Número de Identificación Tributaria (NIT)
860536003
29 . Número documento de identificación
1075625444
25 . DV. 3
26 . Razón social del declarante autorizado 27 . Tipo usuario 28 . Cód. usuario
AGENCIA DE ADUANAS ABC REPECEV S.A.S. NIVEL 1 26 99 30 . Apellidos y nombres
JULIAN APONTE HERNANDEZ
31 . Clase 32 . Tipo declaración 33 . Cod. 34 .No.Formulario Anterior 35 . Año – Mes – Día 36 . Cod. Admón. 37 . Declaración de Exportación 38 . Año – Mes – Día 39 . Cod. Admón. Importador Inicial 1 XXXXXXXXXXXXXX XXXX – XX – XX No. XXXXXXXXXXXXXXX XXXX – XX – XX
02 XX XX
40 . Cod. lugar ingreso 41 . Cod. Depósito 42 . Manifiesto de carga 43 . Año – Mes – Día 44 . Documento de transporte 45 . Año – Mes – Día de las mercancías 99900 No. 116575014151322 2024 – 02 – 13 No. KHAN24025684 2024 – 02 – 09
BOG
46 . Nombre exportador o proveedor en el exterior 47 . Ciudad 48 . Cod.País Exportador SAMSUNG ELECTRONICS CO., LTD GYEONGGI-DO 190
49 . Dirección exportador o proveedor en el exterior 50 . E-mail
129, SAMSUNG-RO, YEONGTONG-GU SUWON 16677 010-8705-6749
51 . No. de factura 52 . Año – Mes – Día 53 . Cod. país 9102341965 2024 – 02 – 07 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
580
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. DHL AERO EXPRESO S A SUCURSAL COLOMBIA
3.954.68
S
59 . Subpartida arancelaria 60 . Cod. 61 . Cod. 62 . Cod. Modalidad 63 . No. cuotas 64 . Valor cuota USD 65 . Periodicidad del 66 . Cod. país 67 . Cod. Acuerdo 8517130000 Complementario Suplementario C134 o meses XXXX pago de la cuota de origen XXX
XXXX XX XX855
68 . Forma de pago 69 . Tipo de 70 . Cod. país de la importación importación compra
01 01 190
71 . Peso bruto kgs. dcms.
72 . Peso neto kgs.
dcms. 73 . Código 117.30 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
127.50
400.00
78 .Valor FOB USD
47.711.13 80 . Valor Seguros
79 . Valor fletes USD
81 . Valor Otros Gastos USD
966.45
0
USD
2.36
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
Arancel
92 93 94 95 96
0.00 192.513.585 0 0 0.00
I.V.A.
9798 99 100 101
0.00 192.513.585 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
968.81
0.00
Salvaguardia
102 103 104 105 106
0.00 0 0 0 0.00
Derechos 107 Compensatorios
108
109
110
111
0.00
0
0
0
0.00
84 . Valor aduana 85 . Código registro 86 . Número
USD
o licencia
48.679.94
X XXXXXXXXXX
Derechos 112 113 114 115 116
Antidumping 0.00 0 0 0 0.00
Sancion
117 118 119 120 0000
87 . Cod. oficina
99
88 . Año 89 . Programa No 90 . Cód Interno del XXXX XXXXXXXXXX Producto
0
Rescate
121 122 123 124 0000
Total
125 126
0 0.00
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: 507244-DECL: 1764976-DO: 893103214241- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN) // NOSACOGEMOS: AL DECRETO 0925 DE 2013, MERC
ANCIA QUE NO REQUIERE REGISTRODE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3058681275. ID CONTEN
EDOR: 6074056029. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A155MZYGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A15 5G DUOS, (CON ACCESO
RIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AMARILLO, MODELO: SM-A155M/DSN, USO O DESTINO: PARA LA VENTA(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 131 . Espacio reservado uso exclusivo Ministerio de Relaciones Exteriores 132 . No. Aceptación declaración Estado de levante: Levante automático 032024000214662
No hay declaración posterior
133. Feha: 202402 14
134 . Levante No. 032024000203707 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 02 – 14
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 92032401172123
Fecha presentación 2024-02-14 14:34:28 Valor pagado $0.00
Fecha de Impresión: 2024-02-14 14:35:04
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000214662-3 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
AL MAYOR Y ALDETAL/ /MOBILE,SM-A155M/DSN,YELLOW,LTC( QTY. 400,00 u )(400,00 PCE);IMEIS: 351864712707656/350563072707659. 3518647
12707680/350563072707683. 351864712707706/350563072707709. 351864712707722/350563072707725. 351864712707730/350563072707733. 3518
64712707748/350563072707741. 351864712707771/350563072707774. 351864712707797/350563072707790. 351864712707839/350563072707832. 3
51864712707854/350563072707857. 351864712707862/350563072707865. 351864712707870/350563072707873. 351864712707888/350563072707881
. 351864712707896/350563072707899. 351864712707904/350563072707907. 351864712707912/350563072707915. 351864712707938/350563072707
931. 351864712707946/350563072707949. 351864712708001/350563072708004. 351864712708027/350563072708020. 351864712708043/350563072
708046.351864712708050/350563072708053. 351864712708076/350563072708079. 351864712708084/350563072708087. 351864712708118/3505630
72708111. 351864712708126/350563072708129. 351864712708159/350563072708152. 351864712708 167/350563072708160. 351864712708175/350
563072708178. 351864712708183/350563072708186. 351864712708191/350563072708194. 351864712708209/350563072708202. 351864712708258/
350563072708251. 351864712708274/350563072708277. 351864712708282/350563072708285. 351864712708308/350563072708301. 3518647127083
16/350563072708319. 351864712708324/350563072708327.351864712708365/350563072708368. 351864712708373/350563072708376. 35186471270
8381/350563072708384. 351864712708407/350563072708400. 351864712708415/350563072708418. 351864712708431/350563072708434. 35186471
2708449/350563072708442. 351864712708456/350563072708459. 351864712708464/350563072708467. 351864712708480/350563072708483. 35186
4712708498/350563072708491. 351864712708506/350563072708509. 351864712708514/350563072708517. 351864712708522/350563072708525. 35
1864712708530/350563072708533. 351864712708548/350563072708541. 351864712708563/350563072708566. 351864712708571/350563072708574.
351864712708589/350563072708582. 351864712708597/350563072708590. 351864712708613/350563072708616. 351864712708621/3505630727086
24. 351864712708639/350563072708632. 351864712708647/350563072708640. 351864712708654/350563072708657. 351864712708662/3505630727
08665. 351864712708670/350563072708673. 351864712708688/350563072708681. 351864712708696/350563072708699. 351864712708712/3505630
72708715. 351864712708720/350563072708723. 351864712708746/350563072708749. 351864712708753/350563072708756. 351864712708761/3505
63072708764. 351864712708779/350563072708772. 351864712708787/350563072708780. 351864712708795/350563072708798. 351864712708803/3
50563072708806. 351864712708811/350563072708814. 351864712708829/350563072708822. 351864712708936/350563072708939. 35186471271134
4/350563072711347. 351864712806110/350563072806113. 351864712806128/350563072806121. 351864712806136/350563072806139. 35186471280
6144/350563072806147. 351864712806151/350563072806154. 351864712806177/350563072806170. 351864712806201/350563072806204. 35186471
2806219/350563072806212. 351864712806235/350563072806238. 351864712806250/350563072806253. 351864712806284/350563072806287.351864
712806334/350563072806337. 351864712703655/350563072703658. 351864712703663/350563072703666. 351864712703689/350563072703682. 351
864712703697/350563072703690. 351864712703713/350563072703716. 351864712703739/350563072703732. 351864712703747/350563072703740.
351864712703754/350563072703757. 351864712703762/350563072703765. 351864712703770/350563072703773. 351864712703788/35056307270378
1. 351864712703796/350563072703799. 351864712703812/350563072703815. 351864712703820/350563072703823. 351864712703838/35056307270
3831. 351864712703846/350563072703849.351864712703861/350563072703864. 351864712703879/350563072703872. 351864712703887/350563072
703880. 351864712703895/350563072703898. 351864712703937/350563072703930. 351864712703945/350563072703948. 351864712704000/350563
072704003. 351864712704059/350563072704052. 351864712704075/350563072704078. 351864712704109/350563072704102. 351864712704125/350
563072704128. 351864712704141/350563072704144. 351864712704158/350563072704151. 351864712704166/350563072704169. 351864712704174/
350563072704177. 351864712704190/350563072704193. 351864712704208/350563072704201. 351864712704216/350563072704219. 3518647127042
24/350563072704227. 351864712704240/350563072704243. 351864712704257/350563072704250. 351864712704265/350563072704268. 3518647127
04273/350563072704276. 351864712704299/350563072704292. 351864712704307/350563072704300. 351864712704315/350563072704318. 3518647
12704364/350563072704367. 351864712704372/350563072704375. 351864712704380/350563072704383. 351864712704398/350563072704391. 3518
64712704414/350563072704417. 351864712704430/350563072704433. 351864712704448/350563072704441. 351864712704455/350563072704458. 3
51864712704463/350563072704466. 351864712704471/350563072704474. 351864712704497/350563072704490. 351864712704505/350563072704508
. 351864712704521/350563072704524. 351864712704539/350563072704532. 351864712704547/350563072704540. 351864712704562/350563072704
565. 351864712704588/350563072704581. 351864712704596/350563072704599. 351864712704612/350563072704615. 351864712704620/350563072
704623. 351864712704638/350563072704631. 351864712704653/350563072704656. 351864712704661/350563072704664. 351864712704679/350563
072704672. 351864712704687/350563072704680. 351864712704703/350563072704706. 351864712704711/350563072704714.351864712704729/3505
63072704722. 351864712704737/350563072704730. 351864712704760/350563072704763. 351864712704778/350563072704771. 351864712704786/3
50563072704789. 351864712704794/350563072704797. 351864712704802/350563072704805. 351864712704828/350563072704821. 35186471270483
6/350563072704839. 351864712704844/350563072704847. 351864712704851/350563072704854. 351864712704877/350563072704870. 35186471270
4893/350563072704896. 351864712704901/350563072704904. 351864712704919/350563072704912. 351864712704927/350563072704920. 35186471
2704935/350563072704938.351864712704943/350563072704946. 351864712704950/350563072704953. 351864712704976/350563072704979. 351864
712704984/350563072704987. 351864712704992/350563072704995. 351864712705007/350563072705000. 351864712705015/350563072705018. 351
864712705023/350563072705026. 351864712705031/350563072705034. 351864712705049/350563072705042. 351864712705072/350563072705075.
351864712705098/350563072705091. 351864712705106/350563072705109. 351864712705114/350563072705117. 351864712705130/35056307270513
3. 351864712705148/350563072705141. 351864712705155/350563072705158. 351864712705163/350563072705166. 351864712705189/35056307270
5182. 351864712705197/350563072705190. 351864712705205/350563072705208. 351864712705213/350563072705216. 351864712705221/35056307
2705224. 351864712705239/350563072705232. 351864712705247/350563072705240. 351864712705254/350563072705257. 351864712705262/35056
3072705265. 351864712705270/350563072705273. 351864712705296/350563072705299. 351864712705304/350563072705307. 351864712705312/35
0563072705315. 351864712705320/350563072705323. 351864712705338/350563072705331. 351864712705353/350563072705356. 351864712705361
/350563072705364. 351864712705452/350563072705455. 351864712705460/350563072705463. 351864712705478/350563072705471. 351864712705
486/350563072705489. 351864712705494/350563072705497. 351864712705502/350563072705505. 351864712705528/350563072705521. 351864712
705569/350563072705562. 351864712705577/350563072705570. 351864712705585/350563072705588. 351864712705601/350563072705604. 351864
712548191/350563072548194. 351864712548217/350563072548210. 351864712548266/350563072548269. 351864712548274/350563072548277. 351
864712548282/350563072548285. 351864712548316/350563072548319. 351864712548324/350563072548327.351864712548332/350563072548335. 3
51864712698681/350563072698684. 351864712702087/350563072702080. 351864712703036/350563072703039. 351864712703085/350563072703088
. 351864712703101/350563072703104. 351864712703119/350563072703112. 351864712703127/350563072703120. 351864712703135/350563072703
138. 351864712703143/350563072703146. 351864712703150/350563072703153. 351864712703168/350563072703161. 351864712703176/350563072
703179. 351864712703184/350563072703187. 351864712703192/350563072703195. 351864712703200/350563072703203. 351864712703218/350563
072703211.351864712703226/350563072703229. 351864712703283/350563072703286. 351864712703358/350563072703351. 351864712703366/3505
63072703369. 351864712703408/350563072703401. 351864712703440/350563072703443. 351864712703457/350563072703450. 351864712703465/3
50563072703468. 351864712703473/350563072703476. 351864712703481/350563072703484. 351864712703499/350563072703492. 35186471270350
7/350563072703500. 351864712703515/350563072703518. 351864712703523/350563072703526. 351864712703531/350563072703534. 35186471270
3564/350563072703567. 351864712703606/350563072703609. 351864712703614/350563072703617. 351864712703622/350563072703625. 35186471
2703630/350563072703633. 351864712705619/350563072705612. 351864712705627/350563072705620. 351864712705643/350563072705646. 35186
4712705734/350563072705737. 351864712705783/350563072705786. 351864712705809/350563072705802. 351864712705817/350563072705810. 35
1864712705825/350563072705828. 351864712705858/350563072705851. 351864712705866/350563072705869. 351864712705874/350563072705877.
351864712705882/350563072705885. 351864712705908/350563072705901. 351864712705940/350563072705943. 351864712705957/3505630727059
50. 351864712705965/350563072705968. 351864712705973/350563072705976. 351864712705981/350563072705984. 351864712705999/3505630727
05992. 351864712706005/350563072706008. 351864712706021/350563072706024. 351864712706039/350563072706032. 351864712706047/3505630
032024000214662-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000214662-3 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
72706040. 351864712706054/350563072706057. 351864712706070/350563072706073. 351864712706088/350563072706081. 351864712706096/3505
63072706099. 351864712706104/350563072706107. 351864712706112/350563072706115. 351864712706120/350563072706123. 351864712706138/3
50563072706131. 351864712706146/350563072706149. 351864712706153/350563072706156.351864712706161/350563072706164. 351864712706179
/350563072706172. 351864712706195/350563072706198. 351864712706211/350563072706214. 351864712706229/350563072706222. 351864712706
237/350563072706230. 351864712706252/350563072706255. 351864712706260/350563072706263. 351864712706278/350563072706271. 351864712
706286/350563072706289. 351864712706302/350563072706305. 351864712706310/350563072706313. 351864712706336/350563072706339. 351864
712706344/350563072706347. 351864712706369/350563072706362. 351864712706377/350563072706370. 351864712706393/350563072706396.3518
64712706401/350563072706404. 351864712706419/350563072706412. 351864712706435/350563072706438. 351864712706443/350563072706446. 3
51864712706450/350563072706453. 351864712706476/350563072706479. 351864712706484/350563072706487. 351864712706500/350563072706503
. 351864712706526/350563072706529. 351864712706534/350563072706537. 351864712706542/350563072706545. 351864712706559/350563072706
552. 351864712706567/350563072706560. 351864712706575/350563072706578. 351864712706583/350563072706586. 351864712706591/350563072
706594. 351864712706609/350563072706602. 351864712706617/350563072706610. 351864712706641/350563072706644. 351864712706658/350563
072706651. 351864712706666/350563072706669. 351864712706674/350563072706677. 351864712706682/350563072706685. 351864712706690/350
563072706693. 351864712706708/350563072706701. 351864712706716/350563072706719. 351864712706724/350563072706727. 351864712706732/
350563072706735. 351864712706740/350563072706743. 351864712706757/350563072706750. 351864712706765/350563072706768. 3518647127067
73/350563072706776. 351864712706781/350563072706784. 351864712706799/350563072706792. 351864712706807/350563072706800. 3518647127
06815/350563072706818. 351864712706831/350563072706834. 351864712706856/350563072706859. 351864712706872/350563072706875. 3518647
12706880/350563072706883. 351864712706898/350563072706891. 351864712706922/350563072706925. 351864712706948/350563072706941. 3518
64712706971/350563072706974. 351864712706997/350563072706990. 351864712707003/350563072707006. 351864712707045/350563072707048. 3
51864712707060/350563072707063. 351864712707078/350563072707071. 351864712707086/350563072707089. 351864712707094/350563072707097
. 351864712707102/350563072707105. 351864712707110/350563072707113.351864712707128/350563072707121. 351864712707136/3505630727071
39. 351864712707144/350563072707147. 351864712707151/350563072707154. 351864712707169/350563072707162. 351864712707177/3505630727
07170. 351864712707185/350563072707188. 351864712707201/350563072707204. 351864712707219/350563072707212. 351864712707227/3505630
72707220. 351864712707235/350563072707238. 351864712707243/350563072707246. 351864712707250/350563072707253. 351864712707268/3505
63072707261. 351864712707276/350563072707279. 351864712707292/350563072707295. 351864712707300/350563072707303.351864712707318/35
0563072707311. 351864712707334/350563072707337. 351864712707342/350563072707345. 351864712707359/350563072707352. 351864712707367
/350563072707360. 351864712707375/350563072707378. 351864712707409/350563072707402. 351864712707433/350563072707436. 351864712707
458/350563072707451. 351864712707557/350563072707550. 351864712707581/350563072707584. 351864712707615/350563072707618XXXXXXXXXXX
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032024000214662-3
Espacio para uso exclusivo de la Entidad Recaudadora
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