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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
032024000798748-3
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 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. 116575014483804 2024 – 06 – 13 No. SHAN0321198 2024 – 06 – 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 9102633946 2024 – 06 – 06 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.
3.938.53
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
855
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 120.00 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
154.00
500.00
78 .Valor FOB 79 . Valor fletes USD USD
62.229.51
1.110.34
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
3.07
0
Arancel
0
0
0.00
92 93 94 0.00 249.477.991
95
96
I.V.A.
9798 99 100 101
0.00 249.477.991 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.113.41
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
63.342.92
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: 519801-DECL: 1808382-DO: 893112854241- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN)// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCAN
CIA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3065778077. ID CONTENED
OR: 6076026777. MERCANCIA MARCA: SAMSUNGREFERENCIA: SM-A155MLBILTC, PRODUCTO: TELEFONO CELULAR GALAXY A15 5G DUOS, (CON ACCESORIO
S PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL CLARO, 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 Estado de levante: Levante automático
No hay declaración posterior
131 . Espacio reservado uso exclusivo Ministerio de Relaciones Exteriores
132 . No. Aceptación declaración 032024000798748
133. Feha: 202406 14
134 . Levante No. 032024000759728 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 06 – 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 92032404363169
Fecha presentación 2024-06-14 17:46:38 Valor pagado $0.00
Fecha de Impresión: 2024-06-14 17:46:43
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000798748-3 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
AL MAYOR Y ALDETAL/ /MOBILE,SM-A155M/DSN,LIGHT BLUE,LTC( QTY. 500,00 u )(500,00 PCE); IMEIS: 355170560338065/355533000338062. 355
170560338073/355533000338070. 355170560338099/355533000338096. 355170560338123/355533000338120. 355170560338156/355533000338153.
355170560338164/355533000338161. 355170560338180/355533000338187. 355170560338206/355533000338203. 355170560338214/35553300033821
1. 355170560338230/355533000338237. 355170560338255/355533000338252. 355170560338263/355533000338260. 355170560338271/35553300033
8278. 355170560338289/355533000338286. 355170560338297/355533000338294. 355170560338313/355533000338310. 355170560338321/35553300
0338328. 355170560338354/355533000338351. 355170560338362/355533000338369. 355170560338370/355533000338377. 355170560338388/35553
3000338385. 355170560338396/355533000338393. 355170560338404/355533000338401. 355170560338412/355533000338419. 355170560338461/35
5533000338468. 355170560338479/355533000338476. 355170560338487/355533000338484. 355170560 338602/355533000338609. 35517056033861
0/355533000338617. 355170560338628/355533000338625. 355170560338644/355533000338641. 355170560338651/355533000338658. 35517056033
8669/355533000338666. 355170560338685/355533000338682. 355170560338792/355533000338799. 355170560339105/355533000339102. 35517056
0339113/355533000339110. 355170560339121/355533000339128. 355170560339154/355533000339151. 355170560339170/355533000339177.355170
560339188/355533000339185. 355170560339204/355533000339201. 355170560339212/355533000339219. 355170560339253/355533000339250. 355
170560339261/355533000339268. 355170560339287/355533000339284. 355170560339295/355533000339292. 355170560339303/355533000339300.
355170560339345/355533000339342. 355170560339378/355533000339375. 355170560339386/355533000339383. 355170560339394/35553300033939
1. 355170560339402/355533000339409. 355170560339410/355533000339417. 355170560339444/355533000339441. 355170560339451/35553300033
9458. 355170560339469/355533000339466.355170560339493/355533000339490. 355170560339501/355533000339508. 355170560339519/355533000
339516. 355170560339527/355533000339524. 355170560339535/355533000339532. 355170560339568/355533000339565. 355170560339576/355533
000339573. 355170560339584/355533000339581. 355170560339592/355533000339599. 355170560339600/355533000339607. 355170560339618/355
533000339615. 355170560339626/355533000339623. 355170560339634/355533000339631. 355170560339642/355533000339649. 355170560339667/
355533000339664. 355170560339675/355533000339672. 355170560339691/355533000339698. 355170560339709/355533000339706. 3551705603397
17/355533000339714. 355170560339733/355533000339730. 355170560339741/355533000339748. 355170560339758/355533000339755. 3551705603
39782/355533000339789. 355170560339808/355533000339805. 355170560339816/355533000339813. 355170560339824/355533000339821. 3551705
60339832/355533000339839. 355170560339857/355533000339854. 355170560339873/355533000339870. 355170560339899/355533000339896. 3551
70560340202/355533000340209. 355170560340210/355533000340217. 355170560340285/355533000340282. 355170560340293/355533000340290. 3
55170560340301/355533000340308. 355170560340327/355533000340324. 355170560340335/355533000340332. 355170560340368/355533000340365
. 355170560340376/355533000340373. 355170560340426/355533000340423. 355170560340434/355533000340431. 355170560340459/355533000340
456. 355170560340475/355533000340472. 355170560340491/355533000340498. 355170560340517/355533000340514. 355170560340525/355533000
340522. 355170560340533/355533000340530. 355170560340541/355533000340548. 355170560340558/355533000340555. 355170560340574/355533
000340571. 355170560340590/355533000340597. 355170560340640/355533000340647. 355170560340665/355533000340662.355170560340681/3555
33000340688. 355170560340723/355533000340720. 355170560340731/355533000340738. 355170560340814/355533000340811. 355170560340962/3
55533000340969. 355170560340970/355533000340977. 355170560340988/355533000340985. 355170560340996/355533000340993. 35517056034100
2/355533000341009. 355170560341028/355533000341025. 355170560341036/355533000341033. 355170560341044/355533000341041. 35517056034
1077/355533000341074. 355170560341135/355533000341132. 355170560341200/355533000341207. 355170560341218/355533000341215. 35517056
0341226/355533000341223.355170560341234/355533000341231. 355170560341242/355533000341249. 355170560341259/355533000341256. 355170
560341267/355533000341264. 355170560341275/355533000341272. 355170560341283/355533000341280. 355170560341291/355533000341298. 355
170560341309/355533000341306. 355170560341325/355533000341322. 355170560341333/355533000341330. 355170560341341/355533000341348.
355170560341358/355533000341355. 355170560341366/355533000341363. 355170560341382/355533000341389. 355170560341390/35553300034139
7. 355170560341440/355533000341447. 355170560341457/355533000341454. 355170560331607/355533000331604. 355170560331615/35553300033
1612. 355170560331623/355533000331620. 355170560331649/355533000331646. 355170560331656/355533000331653. 355170560331672/35553300
0331679. 355170560331680/355533000331687. 355170560331698/355533000331695. 355170560331706/355533000331703. 355170560331748/35553
3000331745. 355170560331755/355533000331752. 355170560331763/355533000331760. 355170560331797/355533000331794. 355170560331813/35
5533000331810. 355170560331839/355533000331836. 355170560331854/355533000331851. 355170560331862/355533000331869. 355170560331870
/355533000331877. 355170560331888/355533000331885. 355170560331904/355533000331901. 355170560331912/355533000331919. 355170560331
920/355533000331927. 355170560331938/355533000331935. 355170560331979/355533000331976. 355170560331987/355533000331984. 355170560
331995/355533000331992. 355170560332001/355533000332008. 355170560332019/355533000332016. 355170560332027/355533000332024. 355170
560332035/355533000332032. 355170560332043/355533000332040. 355170560332050/355533000332057. 355170560332068/355533000332065. 355
170560332076/355533000332073. 355170560332084/355533000332081. 355170560332092/355533000332099.355170560332100/355533000332107. 3
55170560332126/355533000332123. 355170560332134/355533000332131. 355170560332142/355533000332149. 355170560332159/355533000332156
. 355170560332175/355533000332172. 355170560332183/355533000332180. 355170560332191/355533000332198. 355170560332209/355533000332
206. 355170560332225/355533000332222. 355170560332233/355533000332230. 355170560332241/355533000332248. 355170560332258/355533000
332255. 355170560332274/355533000332271. 355170560332290/355533000332297. 355170560332316/355533000332313. 355170560332324/355533
000332321.355170560332332/355533000332339. 355170560332340/355533000332347. 355170560332357/355533000332354. 355170560332365/3555
33000332362. 355170560332407/355533000332404. 355170560332415/355533000332412. 355170560332431/355533000332438. 355170560332449/3
55533000332446. 355170560332456/355533000332453. 355170560332464/355533000332461. 355170560332480/355533000332487. 35517056033249
8/355533000332495. 355170560332530/355533000332537. 355170560332563/355533000332560. 355170560332571/355533000332578. 35517056033
2589/355533000332586. 355170560332704/355533000332701. 355170560332712/355533000332719. 355170560332738/355533000332735. 35517056
0332811/355533000332818. 355170560332845/355533000332842. 355170560332852/355533000332859. 355170560332860/355533000332867. 35517
0560332878/355533000332875. 355170560332886/355533000332883. 355170560333017/355533000333014. 355170560333025/355533000333022. 35
5170560333108/355533000333105. 355170560333132/355533000333139. 355170560333165/355533000333162. 355170560333173/355533000333170.
355170560333199/355533000333196. 355170560333207/355533000333204. 355170560333215/355533000333212. 355170560333231/3555330003332
38. 355170560333249/355533000333246. 355170560333256/355533000333253. 355170560333264/355533000333261. 355170560333272/3555330003
33279. 355170560333280/355533000333287. 355170560333298/355533000333295. 355170560333306/355533000333303. 355170560333314/3555330
00333311. 355170560333322/355533000333329. 355170560333348/355533000333345. 355170560333355/355533000333352. 355170560333371/3555
33000333378. 355170560333389/355533000333386. 355170560333413/355533000333410. 355170560333421/355533000333428. 355170560333439/3
55533000333436. 355170560333447/355533000333444. 355170560333454/355533000333451.355170560333462/355533000333469. 355170560333488
/355533000333485. 355170560333504/355533000333501. 355170560333520/355533000333527. 355170560333538/355533000333535. 355170560333
553/355533000333550. 355170560333561/355533000333568. 355170560333579/355533000333576. 355170560333587/355533000333584. 355170560
333595/355533000333592. 355170560333637/355533000333634. 355170560333645/355533000333642. 355170560333652/355533000333659. 355170
560333660/355533000333667. 355170560333678/355533000333675. 355170560333702/355533000333709. 355170560333710/355533000333717.3551
70560333728/355533000333725. 355170560333736/355533000333733. 355170560333744/355533000333741. 355170560333751/355533000333758. 3
55170560333769/355533000333766. 355170560333777/355533000333774. 355170560333785/355533000333782. 355170560333793/355533000333790
. 355170560333801/355533000333808. 355170560333819/355533000333816. 355170560333827/355533000333824. 355170560333835/355533000333
832. 355170560333843/355533000333840. 355170560333850/355533000333857. 355170560333868/355533000333865. 355170560333876/355533000
333873. 355170560333884/355533000333881. 355170560333892/355533000333899. 355170560333900/355533000333907. 355170560333918/355533
000333915. 355170560333926/355533000333923. 355170560333934/355533000333931. 355170560333942/355533000333949. 355170560333959/355
032024000798748-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000798748-3 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
533000333956. 355170560333967/355533000333964. 355170560333983/355533000333980. 355170560333991/355533000333998. 355170560334049/
355533000334046. 355170560334098/355533000334095. 355170560334106/355533000334103. 355170560334114/355533000334111. 3551705603341
22/355533000334129. 355170560334130/355533000334137. 355170560334148/355533000334145. 355170560334163/355533000334160. 3551705603
34171/355533000334178. 355170560334189/355533000334186. 355170560334197/355533000334194. 355170560334205/355533000334202. 3551705
60334213/355533000334210. 355170560334221/355533000334228. 355170560334239/355533000334236. 355170560334262/355533000334269. 3551
70560334270/355533000334277. 355170560334288/355533000334285. 355170560334296/355533000334293. 355170560334304/355533000334301. 3
55170560334320/355533000334327. 355170560334338/355533000334335. 355170560334346/355533000334343. 355170560334353/355533000334350
. 355170560334361/355533000334368. 355170560334379/355533000334376.355170560334387/355533000334384. 355170560334403/3555330003344
00. 355170560335293/355533000335290. 355170560335434/355533000335431. 355170560335442/355533000335449. 355170560335459/3555330003
35456. 355170560335475/355533000335472. 355170560335483/355533000335480. 355170560335491/355533000335498. 355170560335509/3555330
00335506. 355170560335533/355533000335530. 355170560335566/355533000335563. 355170560335608/355533000335605. 355170560335616/3555
33000335613. 355170560335632/355533000335639. 355170560335665/355533000335662. 355170560335731/355533000335738.355170560335905/35
5533000335902. 355170560335996/355533000335993. 355170560336010/355533000336017. 355170560336028/355533000336025. 355170560336036
/355533000336033. 355170560336044/355533000336041. 355170560336093/355533000336090. 355170560336101/355533000336108. 355170560336
119/355533000336116. 355170560336127/355533000336124. 355170560336135/355533000336132. 355170560336150/355533000336157. 355170560
336168/355533000336165. 355170560336176/355533000336173. 355170560336184/355533000336181. 355170560336200/355533000336207. 355170
560336218/355533000336215. 355170560336226/355533000336223. 355170560336234/355533000336231. 355170560336242/355533000336249. 355
170560336259/355533000336256. 355170560336267/355533000336264. 355170560336275/355533000336272. 355170560336283/355533000336280.
355170560336309/355533000336306. 355170560336317/355533000336314. 355170560336325/355533000336322. 355170560336333/35553300033633
0. 355170560336341/355533000336348. 355170560336358/355533000336355. 355170560334411/355533000334418. 355170560334429/35553300033
4426. 355170560334437/355533000334434. 355170560334445/355533000334442. 355170560334452/355533000334459. 355170560334460/35553300
0334467. 355170560334486/355533000334483. 355170560334494/355533000334491. 355170560334528/355533000334525. 355170560334726/35553
3000334723. 355170560334734/355533000334731. 355170560334775/355533000334772. 355170560334825/355533000334822. 355170560334833/35
5533000334830. 355170560334841/355533000334848. 355170560334858/355533000334855. 355170560334866/355533000334863. 355170560334882
/355533000334889. 355170560334890/355533000334897. 355170560334908/355533000334905. 355170560334916/355533000334913. 355170560334
924/355533000334921. 355170560334999/355533000334996.355170560335004/355533000335001. 355170560335012/355533000335019. 3551705603
35020/355533000335027. 355170560335053/355533000335050. 355170560335061/355533000335068. 355170560335079/355533000335076. 3551705
60335095/355533000335092. 355170560335103/355533000335100. 355170560335111/355533000335118. 355170560335129/355533000335126. 3551
70560335145/355533000335142. 355170560335152/355533000335159. 355170560335160/355533000335167. 355170560335178/355533000335175. 3
55170560335186/355533000335183. 355170560335194/355533000335191. 355170560335202/355533000335209.355170560335210/355533000335217.
355170560335236/355533000335233. 355170560335244/355533000335241. 355170560335251/355533000335258. 355170560336366/3555330003363
63. 355170560336390/355533000336397. 355170560336408/355533000336405. 355170560336416/355533000336413. 355170560336424/3555330003
36421. 355170560336432/355533000336439. 355170560336457/355533000336454. 355170560336473/355533000336470. 355170560336481/3555330
00336488. 355170560336499/355533000336496. 355170560336507/355533000336504. 355170560336523/355533000336520. 355170560336549/3555
33000336546. 355170560336556/355533000336553. 355170560336564/355533000336561. 355170560336598/355533000336595. 355170560336606/3
55533000336603. 355170560336614/355533000336611. 355170560336663/355533000336660. 355170560336671/355533000336678. 35517056033668
9/355533000336686. 355170560336697/355533000336694. 355170560336705/355533000336702. 355170560336713/355533000336710. 35517056033
6721/355533000336728. 355170560336739/355533000336736. 355170560336747/355533000336744. 355170560336770/355533000336777. 35517056
0336796/355533000336793. 355170560336929/355533000336926. 355170560336945/355533000336942. 355170560336952/355533000336959. 35517
0560336960/355533000336967. 355170560336986/355533000336983. 355170560336994/355533000336991. 355170560337018/355533000337015. 35
5170560337026/355533000337023. 355170560337034/355533000337031. 355170560337042/355533000337049. 355170560337059/355533000337056.
355170560337067/355533000337064. 355170560337075/355533000337072. 355170560337083/355533000337080. 355170560337117/3555330003371
14. 355170560337125/355533000337122. 355170560337133/355533000337130. 355170560337141/355533000337148. 355170560337158/3555330003
37155. 355170560337182/355533000337189.355170560337208/355533000337205. 355170560337216/355533000337213. 355170560337224/35553300
0337221. 355170560337257/355533000337254. 355170560337273/355533000337270. 355170560337299/355533000337296. 355170560337307/35553
3000337304. 355170560337315/355533000337312. 355170560337331/355533000337338. 355170560337349/355533000337346. 355170560337356/35
5533000337353. 355170560337364/355533000337361. 355170560337372/355533000337379. 355170560337380/355533000337387. 355170560337398
/355533000337395. 355170560337406/355533000337403. 355170560337422/355533000337429.355170560337430/355533000337437. 3551705603374
48/355533000337445. 355170560337455/355533000337452. 355170560337463/355533000337460. 355170560337471/355533000337478. 3551705603
37547/355533000337544. 355170560337562/355533000337569. 355170560337588/355533000337585. 355170560337604/355533000337601. 3551705
60337612/355533000337619. 355170560337638/355533000337635. 355170560337653/355533000337650. 355170560337679/355533000337676. 3551
70560337695/355533000337692. 355170560337828/355533000337825. 355170560337844/355533000337841. 355170560337901/355533000337908. 3
55170560337919/355533000337916. 355170560337976/355533000337973. 355170560337984/355533000337981. 355170560338008/355533000338005
. 355170560338016/355533000338013. 355170560338024/355533000338021XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024000798748-3
Espacio para uso exclusivo de la Entidad Recaudadora
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