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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
032024000636654-5
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 Anticipada 3 XXXXXXXXXXXXXX XXXX – XX – XX XX No. XXXXXXXXXXXXXXX XXXX – XX – XX XX
02
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. 116575014402530 2024 – 05 – 15 No. T617242559 2024 – 05 – 06
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 6900263321 2024 – 04 – 29 procedencia 215
54 . Cod. Modo Transporte
4
55 . Código de Bandera
169
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. DHL AERO EXPRESO S A SUCURSAL COLOMBIA
3.898.62
S
59 . Subpartida arancelaria 60 . Cod. 8517130000 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 67 . Cod. Acuerdo de origen XXX
215
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 108.40 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
156.00
400.00
78 .Valor FOB 79 . Valor fletes USD USD
29.085.30
1.352.00
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
1.47
0
Arancel
0
0
0.00
92 93 94 0.00 118.669.197
95
96
I.V.A.
9798 99 100 101
0.00 118.669.197 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.353.47
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
30.438.77
X XXXXXXXXXX
Derechos 112 Antidumping
113
114
115
116
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: 516257-DECL: 1794811-DO: 893110192241- 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: 3063591238. ID CONTEN
EDOR: 6075492125. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZSGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS
PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, MODELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYO(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 032024000636654
133. Feha: 202405 10
134 . Levante No. 032024000623799 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 05 – 16
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 92032403473332
Fecha presentación 2024-05-10 12:27:47 Valor pagado $0.00
Fecha de Impresión: 2024-05-16 09:26:54
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000636654-5 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
R Y AL DETAL/ /MOBILE,SM-A055M/DS,SILVER,LTC( QTY. 400,00 u )(400,00 PCE); IMEIS: 358251529395417/359715699395414. 35825152939543
3/359715699395430. 358251529395441/359715699395448. 358251529395599/359715699395596. 358251529395698/359715699395695. 35825152939
5706/359715699395703. 358251529395714/359715699395711. 358251529395722/359715699395729. 358251529395748/359715699395745. 35825152
9395755/359715699395752. 358251529395763/359715699395760. 358251529395771/359715699395778. 358251529395789/359715699395786. 35825
1529395813/359715699395810. 358251529395821/359715699395828. 358251529395839/359715699395836. 358251529395847/359715699395844. 35
8251529395854/359715699395851. 358251529395862/359715699395869. 358251529395870/359715699395877. 358251529395888/359715699395885.
358251529395904/359715699395901. 358251529395912/359715699395919. 358251529395938/359715699395935. 358251529395953/3597156993959
50. 358251529395961/359715699395968. 358251529395979/359715699395976. 358251529396001/359715 699396008. 358251529396035/359715699
396032. 358251529396043/359715699396040. 358251529396068/359715699396065. 358251529396084/359715699396081. 358251529396092/359715
699396099. 358251529396126/359715699396123. 358251529396159/359715699396156. 358251529396167/359715699396164. 358251529396175/359
715699396172. 358251529396183/359715699396180. 358251529396191/359715699396198. 358251529396217/359715699396214. 358251529396225/
359715699396222. 358251529396233/359715699396230. 358251529396241/359715699396248. 358251529396258/359715699396255. 3582515293962
74/359715699396271. 358251529396282/359715699396289. 358251529396290/359715699396297. 358251529396308/359715699396305. 3582515293
96316/359715699396313. 358251529396340/359715699396347. 358251529396365/359715699396362.358251529396373/359715699396370. 35825152
9396381/359715699396388. 358251529396399/359715699396396. 358251529396407/359715699396404. 358251529396415/359715699396412. 35825
1529396423/359715699396420. 358251529396431/359715699396438. 358251529396449/359715699396446. 358251529396464/359715699396461. 35
8251529396472/359715699396479. 358251529396480/359715699396487. 358251529396498/359715699396495. 358251529396555/359715699396552.
358251529396571/359715699396578. 358251529396589/359715699396586. 358251529396597/359715699396594. 358251529396605/3597156993966
02.358251529396613/359715699396610. 358251529396662/359715699396669. 358251529396720/359715699396727. 358251529396753/35971569939
6750. 358251529396761/359715699396768. 358251529396779/359715699396776. 358251529396795/359715699396792. 358251529396845/35971569
9396842. 358251529396894/359715699396891. 358251529396902/359715699396909. 358251529396910/359715699396917. 358251529396928/35971
5699396925. 358251529396977/359715699396974. 358251529396985/359715699396982. 358251529397124/359715699397121. 358251529397132/35
9715699397139. 358251529397215/359715699397212. 358251529397249/359715699397246. 358251529397280/359715699397287. 358251529397298
/359715699397295. 358251529397314/359715699397311. 358251529397330/359715699397337. 358251529400605/359715699400602. 358251529400
621/359715699400628. 358251529400639/359715699400636. 358251529400654/359715699400651. 358251529400670/359715699400677. 358251529
400688/359715699400685. 358251529400696/359715699400693. 358251529400746/359715699400743. 358251529400779/359715699400776. 358251
529400795/359715699400792. 358251529400803/359715699400800. 358251529400837/359715699400834. 358251529400852/359715699400859. 358
251529400860/359715699400867. 358251529400886/359715699400883. 358251529400894/359715699400891. 358251529400902/359715699400909.
358251529400936/359715699400933. 358251529400944/359715699400941. 358251529400951/359715699400958. 358251529400985/35971569940098
2. 358251529400993/359715699400990. 358251529401009/359715699401006. 358251529401017/359715699401014. 358251529401025/35971569940
1022. 358251529401033/359715699401030. 358251529401041/359715699401048. 358251529401058/359715699401055. 358251529401074/35971569
9401071. 358251529401082/359715699401089. 358251529401090/359715699401097.358251529401108/359715699401105. 358251529401116/359715
699401113. 358251529401124/359715699401121. 358251529401132/359715699401139. 358251529401140/359715699401147. 358251529401157/359
715699401154. 358251529401165/359715699401162. 358251529401173/359715699401170. 358251529401181/359715699401188. 358251529401199/
359715699401196. 358251529401207/359715699401204. 358251529401215/359715699401212. 358251529401223/359715699401220. 3582515294012
31/359715699401238. 358251529401249/359715699401246. 358251529401264/359715699401261. 358251529401272/359715699401279.35825152940
1280/359715699401287. 358251529401298/359715699401295. 358251529401306/359715699401303. 358251529401314/359715699401311. 35825152
9401322/359715699401329. 358251529401330/359715699401337. 358251529401348/359715699401345. 358251529401454/359715699401451. 35825
1529401462/359715699401469. 358251529401488/359715699401485. 358251529401496/359715699401493. 358251529401512/359715699401519. 35
8251529401520/359715699401527. 358251529401538/359715699401535. 358251529401546/359715699401543. 358251529401553/359715699401550.
358251529401579/359715699401576. 358251529401587/359715699401584. 358251529401595/359715699401592. 358251529401611/3597156994016
18. 358251529401637/359715699401634. 358251529401645/359715699401642. 358251529401652/359715699401659. 358251529401660/3597156994
01667. 358251529401686/359715699401683. 358251529401694/359715699401691. 358251529401710/359715699401717. 358251529401728/3597156
99401725. 358251529401736/359715699401733. 358251529401751/359715699401758. 358251529401769/359715699401766. 358251529401777/3597
15699401774. 358251529401785/359715699401782. 358251529401819/359715699401816. 358251529401827/359715699401824. 358251529401868/3
59715699401865. 358251529401959/359715699401956. 358251529397355/359715699397352. 358251529397371/359715699397378. 35825152939739
7/359715699397394. 358251529397405/359715699397402. 358251529397447/359715699397444. 358251529397454/359715699397451. 35825152939
7462/359715699397469. 358251529397488/359715699397485. 358251529397496/359715699397493. 358251529397504/359715699397501. 35825152
9397512/359715699397519. 358251529397520/359715699397527. 358251529397538/359715699397535. 358251529397546/359715699397543. 35825
1529397561/359715699397568. 358251529397579/359715699397576.358251529397587/359715699397584. 358251529397595/359715699397592. 358
251529397603/359715699397600. 358251529397611/359715699397618. 358251529397637/359715699397634. 358251529397645/359715699397642.
358251529397652/359715699397659. 358251529397660/359715699397667. 358251529397678/359715699397675. 358251529397686/35971569939768
3. 358251529397694/359715699397691. 358251529397702/359715699397709. 358251529397710/359715699397717. 358251529397728/35971569939
7725. 358251529397736/359715699397733. 358251529397744/359715699397741. 358251529397751/359715699397758.358251529397769/359715699
397766. 358251529397777/359715699397774. 358251529397785/359715699397782. 358251529397801/359715699397808. 358251529397819/359715
699397816. 358251529397835/359715699397832. 358251529397850/359715699397857. 358251529397868/359715699397865. 358251529397884/359
715699397881. 358251529397892/359715699397899. 358251529397900/359715699397907. 358251529397918/359715699397915. 358251529399542/
359715699399549. 358251529399559/359715699399556. 358251529399567/359715699399564. 358251529399583/359715699399580. 3582515293996
09/359715699399606. 358251529399641/359715699399648. 358251529399682/359715699399689. 358251529399708/359715699399705. 3582515293
99716/359715699399713. 358251529399765/359715699399762. 358251529399823/359715699399820. 358251529399849/359715699399846. 3582515
29399872/359715699399879. 358251529399880/359715699399887. 358251529399898/359715699399895. 358251529399955/359715699399952. 3582
51529400019/359715699400016. 358251529400027/359715699400024. 358251529400035/359715699400032. 358251529400068/359715699400065. 3
58251529400076/359715699400073. 358251529400084/359715699400081. 358251529400092/359715699400099. 358251529400100/359715699400107
. 358251529400118/359715699400115. 358251529400126/359715699400123. 358251529400134/359715699400131. 358251529400142/359715699400
149. 358251529400159/359715699400156. 358251529400175/359715699400172. 358251529400183/359715699400180. 358251529400191/359715699
400198. 358251529400209/359715699400206. 358251529400225/359715699400222. 358251529400233/359715699400230. 358251529400258/359715
699400255. 358251529400282/359715699400289. 358251529400290/359715699400297. 358251529400340/359715699400347. 358251529400365/359
715699400362. 358251529400373/359715699400370.358251529400480/359715699400487. 358251529400563/359715699400560. 358251529400589/3
59715699400586. 358251529400597/359715699400594. 358251529398486/359715699398483. 358251529398494/359715699398491. 35825152939850
2/359715699398509. 358251529398510/359715699398517. 358251529398551/359715699398558. 358251529398569/359715699398566. 35825152939
8577/359715699398574. 358251529398585/359715699398582. 358251529398593/359715699398590. 358251529398601/359715699398608. 35825152
9398619/359715699398616. 358251529398627/359715699398624. 358251529398635/359715699398632.358251529398643/359715699398640. 358251
529398650/359715699398657. 358251529398676/359715699398673. 358251529398684/359715699398681. 358251529398692/359715699398699. 358
251529398700/359715699398707. 358251529398718/359715699398715. 358251529398726/359715699398723. 358251529398734/359715699398731.
358251529398742/359715699398749. 358251529398759/359715699398756. 358251529398767/359715699398764. 358251529398775/35971569939877
032024000636654-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000636654-5 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
2. 358251529398783/359715699398780. 358251529398791/359715699398798. 358251529398817/359715699398814. 358251529398825/35971569939
8822. 358251529398833/359715699398830. 358251529398841/359715699398848. 358251529398858/359715699398855. 358251529398866/35971569
9398863. 358251529398874/359715699398871. 358251529398882/359715699398889. 358251529398890/359715699398897. 358251529398908/35971
5699398905. 358251529398924/359715699398921. 358251529398932/359715699398939. 358251529398940/359715699398947. 358251529398957/35
9715699398954. 358251529398965/359715699398962. 358251529398973/359715699398970. 358251529398981/359715699398988. 358251529398999
/359715699398996. 358251529399005/359715699399002. 358251529399013/359715699399010. 358251529399021/359715699399028. 358251529399
039/359715699399036. 358251529399047/359715699399044. 358251529399054/359715699399051. 358251529399062/359715699399069. 358251529
399070/359715699399077. 358251529399088/359715699399085. 358251529399104/359715699399101. 358251529399138/359715699399135. 358251
529399146/359715699399143. 358251529399153/359715699399150. 358251529399161/359715699399168. 358251529399179/359715699399176. 358
251529399187/359715699399184. 358251529399195/359715699399192. 358251529399203/359715699399200. 358251529399211/359715699399218.
358251529399229/359715699399226.358251529399237/359715699399234. 358251529399245/359715699399242. 358251529399252/359715699399259
. 358251529399260/359715699399267. 358251529399278/359715699399275. 358251529399286/359715699399283. 358251529399294/359715699399
291. 358251529399328/359715699399325. 358251529399336/359715699399333. 358251529399351/359715699399358. 358251529399377/359715699
399374. 358251529399385/359715699399382. 358251529399393/359715699399390. 358251529399401/359715699399408. 358251529399427/359715
699399424. 358251529399435/359715699399432. 358251529399443/359715699399440.358251529399450/359715699399457. 358251529399468/3597
15699399465. 358251529399476/359715699399473. 358251529399484/359715699399481. 358251529399500/359715699399507. 358251529399518/3
59715699399515. 358251529399534/359715699399531. 358251529397926/359715699397923. 358251529397942/359715699397949. 35825152939796
7/359715699397964. 358251529397975/359715699397972. 358251529397991/359715699397998. 358251529398007/359715699398004. 35825152939
8015/359715699398012. 358251529398031/359715699398038. 358251529398049/359715699398046. 358251529398056/359715699398053. 35825152
9398064/359715699398061. 358251529398072/359715699398079. 358251529398098/359715699398095. 358251529398106/359715699398103. 35825
1529398114/359715699398111. 358251529398122/359715699398129. 358251529398130/359715699398137. 358251529398148/359715699398145. 35
8251529398155/359715699398152. 358251529398163/359715699398160. 358251529398189/359715699398186. 358251529398197/359715699398194.
358251529398213/359715699398210. 358251529398221/359715699398228. 358251529398239/359715699398236. 358251529398247/3597156993982
44. 358251529398254/359715699398251. 358251529398262/359715699398269. 358251529398270/359715699398277. 358251529398288/3597156993
98285. 358251529398296/359715699398293. 358251529398304/359715699398301. 358251529398312/359715699398319. 358251529398320/3597156
99398327. 358251529398338/359715699398335. 358251529398353/359715699398350. 358251529398379/359715699398376. 358251529398387/3597
15699398384. 358251529398395/359715699398392. 358251529398403/359715699398400. 358251529398411/359715699398418. 358251529398437/3
59715699398434. 358251529398452/359715699398459. 358251529398460/359715699398467. 358251529398478/359715699398475XXXXXXXXXXXXXXXX
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032024000636654-5
Espacio para uso exclusivo de la Entidad Recaudadora
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