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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
032024000179277-0
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 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. 116575014141335 2024 – 02 – 09 No. KHAN24025336 2024 – 02 – 03
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 9102326653 2024 – 02 – 02 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
169
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. TAMPA CARGO S.A.S.
3.889.05
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
48.532.60 80 . Valor Seguros
79 . Valor fletes USD
81 . Valor Otros Gastos USD
966.45
0
USD
2.40
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
Arancel
92 93 94 95 96
0.00 192.513.614 0 0 0.00
I.V.A.
9798 99 100 101
0.00 192.513.614 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
968.85
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
49.501.45
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: 506500-DECL: 1762853-DO: 893102734241- 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: 3058181813. ID CONTENEDOR: 6073968286. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A155MLBGLTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A15 5G DUOS,(CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL (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 032024000179277
No hay declaración posterior
133. Feha: 202402 07
134 . Levante No. 032024000189736 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 02 – 12
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 92032400987415
Fecha presentación 2024-02-07 15:32:13 Valor pagado $0.00
Fecha de Impresión: 2024-02-12 11:27:21
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000179277-0 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
CLARO, MODELO:SM-A155M/DSN, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A155M/DSN,LIGHT BLUE,LTC( QTY. 400,00 u
)(400,00 PCE); IMEIS: 351864712139843/350563072139846. 351864712139850/350563072139853. 351864712139868/350563072139861. 35186471
2139876/350563072139879. 351864712139884/350563072139887. 351864712139892/350563072139895. 351864712139900/350563072139903. 35186
4712139918/350563072139911. 351864712139926/350563072139929. 351864712139934/350563072139937. 351864712139942/350563072139945. 35
1864712139959/350563072139952. 351864712139967/350563072139960. 351864712139975/350563072139978. 351864712139983/350563072139986.
351864712139991/350563072139994. 351864712140007/350563072140000. 351864712140015/350563072140018. 351864712140023/3505630721400
26. 351864712140031/350563072140034. 351864712140049/350563072140042. 351864712140056/350563072140059. 351864712140064/3505630721
40067. 351864712140072/350563072140075. 351864712140080/350563072140083. 351864712140098/35 0563072140091. 351864712140106/350563
072140109. 351864712140114/350563072140117. 351864712140122/350563072140125. 351864712140130/350563072140133. 351864712140148/350
563072140141. 351864712140155/350563072140158. 351864712140163/350563072140166. 351864712140171/350563072140174. 351864712140189/
350563072140182. 351864712140197/350563072140190. 351864712140205/350563072140208. 351864712140213/350563072140216. 3518647121402
21/350563072140224. 351864712140239/350563072140232. 351864712140247/350563072140240. 351864712140254/350563072140257. 3518647121
40262/350563072140265. 351864712140270/350563072140273. 351864712143993/350563072143996. 351864712144009/350563072144002. 3518647
12144017/350563072144010. 351864712144025/350563072144028. 351864712144033/350563072144036. 351864712144058/350563072144051. 3518
64712144074/350563072144077.351864712144082/350563072144085. 351864712144116/350563072144119. 351864712144124/350563072144127. 35
1864712144132/350563072144135. 351864712144140/350563072144143. 351864712144165/350563072144168. 351864712144199/350563072144192.
351864712144223/350563072144226. 351864712144231/350563072144234. 351864712144298/350563072144291. 351864712144314/3505630721443
17. 351864712144330/350563072144333. 351864712144348/350563072144341. 351864712144371/350563072144374. 351864712144397/3505630721
44390. 351864712195951/350563072195954. 351864712195977/350563072195970.351864712195985/350563072195988. 351864712195993/35056307
2195996. 351864712196009/350563072196002. 351864712196025/350563072196028. 351864712196033/350563072196036. 351864712196066/35056
3072196069. 351864712196074/350563072196077. 351864712196082/350563072196085. 351864712196090/350563072196093. 351864712196108/35
0563072196101. 351864712196116/350563072196119. 351864712196124/350563072196127. 351864712196132/350563072196135. 351864712196140
/350563072196143. 351864712196199/350563072196192. 351864712196272/350563072196275. 351864712196306/350563072196309. 351864712196
330/350563072196333. 351864712196512/350563072196515. 351864712196637/350563072196630. 351864712143308/350563072143301. 351864712
143316/350563072143319. 351864712143332/350563072143335. 351864712143373/350563072143376. 351864712143407/350563072143400. 351864
712143415/350563072143418. 351864712143456/350563072143459. 351864712143472/350563072143475. 351864712143480/350563072143483. 351
864712143498/350563072143491. 351864712143530/350563072143533. 351864712143548/350563072143541. 351864712143571/350563072143574.
351864712143597/350563072143590. 351864712143605/350563072143608. 351864712143613/350563072143616. 351864712143621/35056307214362
4. 351864712143639/350563072143632. 351864712143654/350563072143657. 351864712143662/350563072143665. 351864712143670/35056307214
3673. 351864712143688/350563072143681. 351864712143712/350563072143715. 351864712143720/350563072143723. 351864712143738/35056307
2143731. 351864712143753/350563072143756. 351864712143795/350563072143798. 351864712143803/350563072143806. 351864712143829/35056
3072143822. 351864712143837/350563072143830. 351864712143845/350563072143848. 351864712143852/350563072143855. 351864712143860/35
0563072143863.351864712143878/350563072143871. 351864712143886/350563072143889. 351864712143894/350563072143897. 351864712143902/
350563072143905. 351864712143910/350563072143913. 351864712143928/350563072143921. 351864712143936/350563072143939. 3518647121439
44/350563072143947. 351864712143951/350563072143954. 351864712143977/350563072143970. 351864712143985/350563072143988. 3518647121
96736/350563072196739. 351864712198153/350563072198156. 351864712198161/350563072198164. 351864712198203/350563072198206. 3518647
12198211/350563072198214. 351864712198229/350563072198222.351864712198260/350563072198263. 351864712198682/350563072198685. 35186
4712198724/350563072198727. 351864712198732/350563072198735. 351864712198781/350563072198784. 351864712198807/350563072198800. 35
1864712198815/350563072198818. 351864712198831/350563072198834. 351864712198955/350563072198958. 351864712199169/350563072199162.
351864712199789/350563072199782. 351864712199847/350563072199840. 351864712199854/350563072199857. 351864712199979/3505630721999
72. 351864712199995/350563072199998. 351864712200041/350563072200044. 351864712200058/350563072200051. 351864712200074/3505630722
00077. 351864712200090/350563072200093. 351864712200116/350563072200119. 351864712200124/350563072200127. 351864712200140/3505630
72200143. 351864712200157/350563072200150. 351864712200165/350563072200168. 351864712200173/350563072200176. 351864712200256/3505
63072200259. 351864712200314/350563072200317. 351864712200322/350563072200325. 351864712200330/350563072200333. 351864712200348/3
50563072200341. 351864712200397/350563072200390. 351864712200413/350563072200416. 351864712200439/350563072200432. 35186471220044
7/350563072200440. 351864712200454/350563072200457. 351864712200470/350563072200473. 351864712200488/350563072200481. 35186471220
0504/350563072200507. 351864712134034/350563072134037. 351864712134042/350563072134045. 351864712134059/350563072134052. 35186471
2134083/350563072134086. 351864712134091/350563072134094. 351864712134109/350563072134102. 351864712134117/350563072134110. 35186
4712134125/350563072134128. 351864712134133/350563072134136. 351864712134141/350563072134144. 351864712134158/350563072134151. 35
1864712134166/350563072134169. 351864712134174/350563072134177. 351864712134182/350563072134185. 351864712134190/350563072134193.
351864712134224/350563072134227. 351864712134232/350563072134235. 351864712134240/350563072134243. 351864712134257/35056307213425
0. 351864712134265/350563072134268. 351864712134273/350563072134276. 351864712134281/350563072134284. 351864712134299/35056307213
4292. 351864712134307/350563072134300. 351864712134331/350563072134334. 351864712134349/350563072134342. 351864712134356/35056307
2134359. 351864712134372/350563072134375. 351864712134398/350563072134391. 351864712134406/350563072134409. 351864712134414/35056
3072134417. 351864712134422/350563072134425.351864712134430/350563072134433. 351864712134448/350563072134441. 351864712134455/350
563072134458. 351864712134554/350563072134557. 351864712134562/350563072134565. 351864712134570/350563072134573. 351864712134596/
350563072134599. 351864712134604/350563072134607. 351864712134612/350563072134615. 351864712134638/350563072134631. 3518647121346
46/350563072134649. 351864712134661/350563072134664. 351864712139280/350563072139283. 351864712139298/350563072139291. 3518647121
39306/350563072139309. 351864712139348/350563072139341. 351864712139355/350563072139358. 351864712139363/350563072139366. 3518647
12139371/350563072139374. 351864712139389/350563072139382. 351864712139397/350563072139390. 351864712139405/350563072139408. 3518
64712139439/350563072139432. 351864712139462/350563072139465. 351864712139470/350563072139473. 351864712139488/350563072139481. 3
51864712139496/350563072139499. 351864712139504/350563072139507. 351864712139512/350563072139515. 351864712139520/350563072139523
. 351864712139538/350563072139531. 351864712139546/350563072139549. 351864712139553/350563072139556. 351864712139561/350563072139
564. 351864712139579/350563072139572. 351864712139587/350563072139580. 351864712139595/350563072139598. 351864712139603/350563072
139606. 351864712139611/350563072139614. 351864712139629/350563072139622. 351864712139645/350563072139648. 351864712139660/350563
072139663. 351864712139678/350563072139671. 351864712139694/350563072139697. 351864712139702/350563072139705. 351864712139710/350
563072139713. 351864712139728/350563072139721. 351864712139736/350563072139739. 351864712139744/350563072139747. 351864712139751/
350563072139754. 351864712139769/350563072139762. 351864712139793/350563072139796. 351864712139801/350563072139804.35186471213981
9/350563072139812. 351864712139827/350563072139820. 351864712139835/350563072139838. 351864712140288/350563072140281. 35186471214
0296/350563072140299. 351864712140304/350563072140307. 351864712140312/350563072140315. 351864712140320/350563072140323. 35186471
2140338/350563072140331. 351864712140346/350563072140349. 351864712140353/350563072140356. 351864712140361/350563072140364. 35186
4712140379/350563072140372. 351864712140387/350563072140380. 351864712140395/350563072140398. 351864712140403/350563072140406. 35
1864712140411/350563072140414.351864712140429/350563072140422. 351864712140437/350563072140430. 351864712140445/350563072140448.
351864712140460/350563072140463. 351864712140478/350563072140471. 351864712140486/350563072140489. 351864712140494/35056307214049
7. 351864712140742/350563072140745. 351864712141377/350563072141370. 351864712141419/350563072141412. 351864712141674/35056307214
032024000179277-0
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000179277-0 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
1677. 351864712141724/350563072141727. 351864712141732/350563072141735. 351864712141740/350563072141743. 351864712141799/35056307
2141792. 351864712142052/350563072142055. 351864712142292/350563072142295. 351864712142359/350563072142352. 351864712142458/35056
3072142451. 351864712142698/350563072142691. 351864712142763/350563072142766. 351864712143076/350563072143079. 351864712143118/35
0563072143111. 351864712143209/350563072143202. 351864712143225/350563072143228. 351864712143258/350563072143251. 351864712143266
/350563072143269. 351864712143274/350563072143277. 351864712143282/350563072143285. 351864712143290/350563072143293. 351864712134
687/350563072134680. 351864712134786/350563072134789. 351864712135155/350563072135158. 351864712135205/350563072135208. 351864712
135213/350563072135216. 351864712135221/350563072135224. 351864712135346/350563072135349. 351864712135767/350563072135760. 351864
712136898/350563072136891. 351864712136906/350563072136909. 351864712136914/350563072136917. 351864712136922/350563072136925. 351
864712136930/350563072136933. 351864712136948/350563072136941. 351864712136997/350563072136990. 351864712137003/350563072137006.
351864712138993/350563072138996. 351864712139009/350563072139002. 351864712139017/350563072139010. 351864712139025/35056307213902
8. 351864712139033/350563072139036. 351864712139041/350563072139044. 351864712139058/350563072139051.351864712139066/350563072139
069. 351864712139074/350563072139077. 351864712139082/350563072139085. 351864712139090/350563072139093. 351864712139108/350563072
139101. 351864712139116/350563072139119. 351864712139124/350563072139127. 351864712139132/350563072139135. 351864712139140/350563
072139143. 351864712139157/350563072139150. 351864712139165/350563072139168. 351864712139173/350563072139176. 351864712139181/350
563072139184. 351864712139199/350563072139192. 351864712139207/350563072139200. 351864712139215/350563072139218. 351864712139223/
350563072139226.351864712139249/350563072139242. 351864712139256/350563072139259. 351864712139264/350563072139267. 35186471213927
2/350563072139275. 351864712200538/350563072200531. 351864712200546/350563072200549. 351864712200553/350563072200556. 35186471220
0579/350563072200572. 351864712200595/350563072200598. 351864712200611/350563072200614. 351864712200629/350563072200622. 35186471
2200678/350563072200671. 351864712200686/350563072200689. 351864712200694/350563072200697. 351864712200728/350563072200721. 35186
4712200736/350563072200739. 351864712200751/350563072200754. 351864712200769/350563072200762. 351864712200777/350563072200770. 35
1864712200785/350563072200788. 351864712200801/350563072200804. 351864712200819/350563072200812. 351864712200835/350563072200838.
351864712200843/350563072200846. 351864712200850/350563072200853. 351864712200868/350563072200861. 351864712200876/3505630722008
79. 351864712200884/350563072200887. 351864712200892/350563072200895. 351864712200900/350563072200903. 351864712200926/3505630722
00929. 351864712200934/350563072200937. 351864712200942/350563072200945. 351864712200959/350563072200952. 351864712200967/3505630
72200960. 351864712200975/350563072200978. 351864712200991/350563072200994. 351864712201007/350563072201000. 351864712201023/3505
63072201026. 351864712201031/350563072201034. 351864712201049/350563072201042. 351864712201056/350563072201059. 351864712201064/3
50563072201067. 351864712201072/350563072201075. 351864712201080/350563072201083. 351864712201098/350563072201091. 35186471220110
6/350563072201109. 351864712201114/350563072201117. 351864712201122/350563072201125. 351864712201148/350563072201141. 35186471220
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032024000179277-0
Espacio para uso exclusivo de la Entidad Recaudadora
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