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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
032024000980280-8
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. 116575014596884 2024 – 07 – 21 No. SHAN0330494 2024 – 07 – 13
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 9102728921 2024 – 07 – 13 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.
3.968.87
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 96.00 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
127.50
400.00
78 .Valor FOB 79 . Valor fletes USD USD
39.518.24
914.18
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
1.96
0
Arancel
0
0
0.00
92 93 94 0.00 160.478.798
95
96
I.V.A.
9798 99 100 101
0.00 160.478.798 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
916.14
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
40.434.38
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: 524000-DECL: 1820652-DO: 893116428241- 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: 3068702144. ID CONTEN
EDOR: 6076763567. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A155MLBGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A15 5GDUOS,(CON ACCESORI
OS 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 032024000980280
133. Feha: 202407 18
134 . Levante No. 032024000931606 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 07 – 22
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 92032405316367
Fecha presentación 2024-07-18 19:52:50 Valor pagado $0.00
Fecha de Impresión: 2024-07-22 14:31:13
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000980280-8 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. 400,00 u )(400,00 PCE); IMEIS: 352749385102609/354804945102603. 35
2749385103466/354804945103460. 352749385103649/354804945103643. 352749385104548/354804945104542. 352749385106170/354804945106174.
352749385216870/354804945216874. 352749385216912/354804945216916. 352749385216938/354804945216932. 352749385216979/3548049452169
73. 352749385217019/354804945217013. 352749385217027/354804945217021. 352749385217035/354804945217039. 352749385217217/3548049452
17211. 352749385217225/354804945217229. 352749385217233/354804945217237. 352749385217258/354804945217252. 352749385217480/3548049
45217484. 352749385217555/354804945217559. 352749385217571/354804945217575. 352749385217639/354804945217633. 352749385217696/3548
04945217690. 352749385218017/354804945218011. 352749385218025/354804945218029.352749385218033/354804945218037. 352749385218041/35
4804945218045. 352749385218058/354804945218052. 352749385218108/354804945218102. 35274938 5218116/354804945218110. 35274938521813
2/354804945218136. 352749385218140/354804945218144. 352749385218538/354804945218532. 352749385218959/354804945218953. 35274938521
9064/354804945219068. 352749385219098/354804945219092. 352749385219106/354804945219100. 352749385219122/354804945219126. 35274938
5219130/354804945219134. 352749385219189/354804945219183. 352749385219197/354804945219191. 352749385219213/354804945219217.352749
385219221/354804945219225. 352749385219262/354804945219266. 352749385219270/354804945219274. 352749385219288/354804945219282. 352
749385219320/354804945219324. 352749385219338/354804945219332. 352749385219353/354804945219357. 352749385219379/354804945219373.
352749385219403/354804945219407. 352749385219445/354804945219449. 352749385219593/354804945219597. 352749385219650/35480494521965
4. 352749385219890/354804945219894. 352749385219924/354804945219928. 352749385219981/354804945219985. 352749385220062/35480494522
0066. 352749385220096/354804945220090. 352749385220104/354804945220108. 352749385220195/354804945220199. 352749385220203/35480494
5220207. 352749385220773/354804945220777. 352749385220823/354804945220827. 352749385220831/354804945220835. 352749385220849/35480
4945220843. 352749385220856/354804945220850. 352749385220872/354804945220876. 352749385220880/354804945220884. 352749385220898/35
4804945220892. 352749385220906/354804945220900. 352749385220914/354804945220918. 352749385220930/354804945220934. 352749385220955
/354804945220959. 352749385221219/354804945221213. 352749385221250/354804945221254. 352749385221326/354804945221320. 352749385221
383/354804945221387. 352749385221425/354804945221429. 352749385221573/354804945221577. 352749385221581/354804945221585. 352749385
221607/354804945221601. 352749385221656/354804945221650. 352749385221664/354804945221668. 352749385221672/354804945221676. 352749
385221680/354804945221684. 352749385221748/354804945221742. 352749385221755/354804945221759. 352749385221763/354804945221767. 352
749385221771/354804945221775. 352749385221789/354804945221783. 352749385221797/354804945221791. 352749385221813/354804945221817.
352749385221821/354804945221825. 352749385221839/354804945221833.352749385221847/354804945221841. 352749385221862/354804945221866
. 352749385221870/354804945221874. 352749385221888/354804945221882. 352749385221896/354804945221890. 352749385221904/354804945221
908. 352749385221920/354804945221924. 352749385221938/354804945221932. 352749385221946/354804945221940. 352749385221953/354804945
221957. 352749385221961/354804945221965. 352749385221979/354804945221973. 352749385221987/354804945221981. 352749385221995/354804
945221999. 352749385222001/354804945222005. 352749385222019/354804945222013. 352749385222027/354804945222021.352749385222043/3548
04945222047. 352749385222050/354804945222054. 352749385222068/354804945222062. 352749385222076/354804945222070. 352749385222084/3
54804945222088. 352749385222092/354804945222096. 352749385222118/354804945222112. 352749385222134/354804945222138. 35274938522214
2/354804945222146. 352749385222175/354804945222179. 352749385222191/354804945222195. 352749385222209/354804945222203. 35274938522
2266/354804945222260. 352749385222274/354804945222278. 352749385222282/354804945222286. 352749385222290/354804945222294. 35274938
5222308/354804945222302. 352749385222324/354804945222328. 352749385222415/354804945222419. 352749385222456/354804945222450. 35274
9385222464/354804945222468. 352749385222647/354804945222641. 352749385222738/354804945222732. 352749385222803/354804945222807. 35
2749385222811/354804945222815. 352749385223025/354804945223029. 352749385223306/354804945223300. 352749385223363/354804945223367.
352749385223454/354804945223458. 352749385223470/354804945223474. 352749385223504/354804945223508. 352749385223587/3548049452235
81. 352749385223603/354804945223607. 352749385223611/354804945223615. 352749385223694/354804945223698. 352749385223728/3548049452
23722. 352749385223751/354804945223755. 352749385223868/354804945223862. 352749385223892/354804945223896. 352749385223900/3548049
45223904. 352749385224429/354804945224423. 352749385225178/354804945225172. 352749385225277/354804945225271. 352749385225327/3548
04945225321. 352749385225418/354804945225412. 352749385225517/354804945225511. 352749385226622/354804945226626. 352749385226655/3
54804945226659. 352749385226671/354804945226675. 352749385226713/354804945226717. 352749385226754/354804945226758. 35274938522681
2/354804945226816. 352749385226820/354804945226824.352749385226838/354804945226832. 352749385226846/354804945226840. 352749385226
853/354804945226857. 352749385226861/354804945226865. 352749385226879/354804945226873. 352749385226903/354804945226907. 352749385
226937/354804945226931. 352749385226945/354804945226949. 352749385226952/354804945226956. 352749385226978/354804945226972. 352749
385226986/354804945226980. 352749385226994/354804945226998. 352749385227000/354804945227004. 352749385227026/354804945227020. 352
749385227034/354804945227038. 352749385227042/354804945227046. 352749385227059/354804945227053.352749385227083/354804945227087. 3
52749385227091/354804945227095. 352749385227109/354804945227103. 352749385227117/354804945227111. 352749385227125/354804945227129
. 352749385227133/354804945227137. 352749385227158/354804945227152. 352749385227166/354804945227160. 352749385227174/354804945227
178. 352749385227182/354804945227186. 352749385227190/354804945227194. 352749385227216/354804945227210. 352749385227224/354804945
227228. 352749385227240/354804945227244. 352749385227257/354804945227251. 352749385227265/354804945227269. 352749385227281/354804
945227285. 352749385227299/354804945227293. 352749385227307/354804945227301. 352749385227315/354804945227319. 352749385227323/354
804945227327. 352749385227331/354804945227335. 352749385227349/354804945227343. 352749385227356/354804945227350. 352749385227364/
354804945227368. 352749385227372/354804945227376. 352749385227380/354804945227384. 352749385227398/354804945227392. 3527493852274
14/354804945227418. 352749385227448/354804945227442. 352749385227463/354804945227467. 352749385227471/354804945227475. 3527493852
27489/354804945227483. 352749385227497/354804945227491. 352749385227505/354804945227509. 352749385227513/354804945227517. 3527493
85227521/354804945227525. 352749385227547/354804945227541. 352749385227562/354804945227566. 352749385227570/354804945227574. 3527
49385227588/354804945227582. 352749385227596/354804945227590. 352749385227604/354804945227608. 352749385227612/354804945227616. 3
52749385227828/354804945227822. 352749385227836/354804945227830. 352749385227844/354804945227848. 352749385227869/354804945227863
. 352749385227877/354804945227871. 352749385227885/354804945227889. 352749385227901/354804945227905. 352749385227919/354804945227
913. 352749385227935/354804945227939.352749385227943/354804945227947. 352749385227950/354804945227954. 352749385227968/3548049452
27962. 352749385227976/354804945227970. 352749385227984/354804945227988. 352749385227992/354804945227996. 352749385228008/3548049
45228002. 352749385228016/354804945228010. 352749385228024/354804945228028. 352749385228032/354804945228036. 352749385228040/3548
04945228044. 352749385228057/354804945228051. 352749385228065/354804945228069. 352749385228073/354804945228077. 352749385228081/3
54804945228085. 352749385228107/354804945228101. 352749385228156/354804945228150.352749385228180/354804945228184. 352749385228206
/354804945228200. 352749385228222/354804945228226. 352749385228230/354804945228234. 352749385228263/354804945228267. 352749385228
271/354804945228275. 352749385228289/354804945228283. 352749385228305/354804945228309. 352749385228321/354804945228325. 352749385
228354/354804945228358. 352749385228388/354804945228382. 352749385228412/354804945228416. 352749385228446/354804945228440. 352749
385228453/354804945228457. 352749385228487/354804945228481. 352749385228495/354804945228499. 352749385228610/354804945228614. 352
749385228644/354804945228648. 352749385228933/354804945228937. 352749385228941/354804945228945. 352749385228990/354804945228994.
352749385229220/354804945229224. 352749385229253/354804945229257. 352749385229618/354804945229612. 352749385229733/35480494522973
7. 352749385230525/354804945230529. 352749385230764/354804945230768. 352749385230772/354804945230776. 352749385230780/35480494523
0784. 352749385231267/354804945231261. 352749385231408/354804945231402. 352749385231481/354804945231485. 352749385231531/35480494
5231535. 352749385231796/354804945231790. 352749385232133/354804945232137. 352749385232166/354804945232160. 352749385232257/35480
4945232251. 352749385232273/354804945232277. 352749385232349/354804945232343. 352749385232513/354804945232517. 352749385232851/35
032024000980280-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000980280-8 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
4804945232855. 352749385233446/354804945233440. 352749385235664/354804945235668. 352749385289661/354804945289665. 352749385289687
/354804945289681. 352749385289711/354804945289715. 352749385289729/354804945289723. 352749385289760/354804945289764. 352749385289
778/354804945289772. 352749385289786/354804945289780. 352749385289810/354804945289814. 352749385289836/354804945289830. 352749385
290917/354804945290911.352749385290982/354804945290986. 352749385291014/354804945291018. 352749385291030/354804945291034. 3527493
85291048/354804945291042. 352749385291063/354804945291067. 352749385291071/354804945291075. 352749385291105/354804945291109. 3527
49385291113/354804945291117. 352749385291121/354804945291125. 352749385291139/354804945291133. 352749385291154/354804945291158. 3
52749385291170/354804945291174. 352749385291188/354804945291182. 352749385291253/354804945291257. 352749385291261/354804945291265
. 352749385291303/354804945291307. 352749385291329/354804945291323.352749385291386/354804945291380. 352749385291402/3548049452914
06. 352749385291410/354804945291414. 352749385291428/354804945291422. 352749385291444/354804945291448. 352749385291493/3548049452
91497. 352749385291501/354804945291505. 352749385291519/354804945291513. 352749385291527/354804945291521. 352749385291550/3548049
45291554. 352749385291576/354804945291570. 352749385291626/354804945291620. 352749385291642/354804945291646. 352749385293200/3548
04945293204. 352749385293275/354804945293279. 352749385293341/354804945293345. 352749385293440/354804945293444. 352749385295544/3
54804945295548. 352749385295551/354804945295555. 352749385295569/354804945295563. 352749385295684/354804945295688. 35274938529571
8/354804945295712. 352749385295775/354804945295779. 352749385296369/354804945296363. 352749385296393/354804945296397. 35274938529
6435/354804945296439. 352749385296476/354804945296470. 352749385296781/354804945296785. 352749385296799/354804945296793. 35274938
5296807/354804945296801. 352749385296815/354804945296819. 352749385296831/354804945296835. 352749385296849/354804945296843. 35274
9385296856/354804945296850. 352749385296864/354804945296868. 352749385296880/354804945296884. 352749385296898/354804945296892. 35
2749385296906/354804945296900. 352749385296914/354804945296918. 352749385296922/354804945296926. 352749385296930/354804945296934.
352749385296948/354804945296942. 352749385296955/354804945296959. 352749385296963/354804945296967. 352749385296971/3548049452969
75. 352749385296997/354804945296991. 352749385297037/354804945297031. 352749385297086/354804945297080. 352749385297102/3548049452
97106. 352749385297136/354804945297130. 352749385297169/354804945297163. 352749385297177/354804945297171. 352749385297219/3548049
45297213.352749385297235/354804945297239. 352749385297276/354804945297270. 352749385297318/354804945297312. 352749385297581/35480
4945297585. 352749385317975/354804945317979. 352749385318007/354804945318001. 352749385318056/354804945318050. 352749385318064/35
4804945318068. 352749385318098/354804945318092. 352749385318122/354804945318126. 352749385318148/354804945318142. 352749385318197
/354804945318191. 352749385318361/354804945318365. 352749385320409/354804945320403. 352749385320516/354804945320510. 352749385320
599/354804945320593. 352749385320623/354804945320627.352749385320631/354804945320635. 352749385320656/354804945320650. 3527493853
20672/354804945320676. 352749385320680/354804945320684. 352749385320748/354804945320742. 352749385320904/354804945320908. 3527493
85320912/354804945320916. 352749385323965/354804945323969. 352749385324328/354804945324322. 352749385324930/354804945324934XXXXXX
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032024000980280-8
Espacio para uso exclusivo de la Entidad Recaudadora
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