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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
032024001257512-5
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
102294385
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
CARLOS ANDRES ROJAS MATAJUDIOS
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. 116575014759657 2024 – 09 – 10 No. HKQ007166 2024 – 09 – 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 6900296265 2024 – 08 – 30 procedencia 351
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.
4.172.50
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 105.60 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
136.00
400.00
78 .Valor FOB 79 . Valor fletes USD USD
25.154.72
916.64
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
1.26
0
Arancel
0
0
0.00
92 93 94 0.00 108.788.007
95
96
I.V.A.
9798 99 100 101
0.00 108.788.007 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
917.90
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
26.072.62
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: 530224-DECL: 1837745-DO: 893121097241- 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: 3072688420. ID CONTEN
EDOR: 6077886309. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A057MLVGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A05S DUOS, (CON ACCESORI
OS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VIOLETACLARO, MODELO: SM-A057M/DS, USO O DESTINO: PARA LA VENT(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 032024001257512
133. Feha: 202409 11
134 . Levante No. 032024001181924 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 11
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 92032406745885
Fecha presentación 2024-09-11 13:39:17 Valor pagado $0.00
Fecha de Impresión: 2024-09-11 13:39:22
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001257512-5 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
A AL MAYOR Y AL DETAL/ /MOBILE,SM-A057M,LIGHT VIOLET,LTC( QTY. 400,00 u )(400,00 PCE); IMEIS: 350290617964633/355253227964638. 35
0290617964641/355253227964646. 350290617964716/355253227964711. 350290617964724/355253227964729. 350290617964740/355253227964745.
350290617964765/355253227964760. 350290617964799/355253227964794. 350290617964807/355253227964802. 350290617964815/3552532279648
10. 350290617964823/355253227964828. 350290617964831/355253227964836. 350290617964849/355253227964844. 350290617964856/3552532279
64851. 350290617964864/355253227964869. 350290617964872/355253227964877. 350290617964898/355253227964893. 350290617964906/3552532
27964901. 350290617964914/355253227964919. 350290617964922/355253227964927. 350290617964930/355253227964935. 350290617964948/3552
53227964943. 350290617964955/355253227964950. 350290617964963/355253227964968. 350290617964971/355253227964976. 350290617964989/3
55253227964984. 350290617964997/355253227964992. 350290617965010/355253227965015. 350290617 965028/355253227965023. 3502906179650
36/355253227965031. 350290617965044/355253227965049. 350290617965051/355253227965056. 350290617965069/355253227965064. 3502906179
65077/355253227965072. 350290617965085/355253227965080. 350290617965093/355253227965098. 350290617965127/355253227965122. 3502906
17965143/355253227965148. 350290617965150/355253227965155. 350290617965168/355253227965163. 350290617965176/355253227965171.35029
0617965184/355253227965189. 350290617965192/355253227965197. 350290617965234/355253227965239. 350290617965242/355253227965247. 35
0290617965259/355253227965254. 350290617965267/355253227965262. 350290617965275/355253227965270. 350290617965283/355253227965288.
350290617965333/355253227965338. 350290617965341/355253227965346. 350290617965366/355253227965361. 350290617965374/3552532279653
79. 350290617965424/355253227965429. 350290617965440/355253227965445. 350290617965465/355253227965460. 350290617965499/3552532279
65494. 350290617965515/355253227965510.350290617965523/355253227965528. 350290617965572/355253227965577. 350290617965580/35525322
7965585. 350290617965598/355253227965593. 350290617965614/355253227965619. 350290617965622/355253227965627. 350290617965630/35525
3227965635. 350290617965655/355253227965650. 350290617965663/355253227965668. 350290617965689/355253227965684. 350290617965697/35
5253227965692. 350290617965705/355253227965700. 350290617965713/355253227965718. 350290617965721/355253227965726. 350290617965739
/355253227965734. 350290617965747/355253227965742. 350290617965762/355253227965767. 350290617965770/355253227965775. 350290617965
788/355253227965783. 350290617965796/355253227965791. 350290617965804/355253227965809. 350290617965812/355253227965817. 350290617
965820/355253227965825. 350290617965838/355253227965833. 350290617965846/355253227965841. 350290617965853/355253227965858. 350290
617965861/355253227965866. 350290617965895/355253227965890. 350290617965911/355253227965916. 350290617965929/355253227965924. 350
290617965937/355253227965932. 350290617965952/355253227965957. 350290617965978/355253227965973. 350290617965986/355253227965981.
350290617965994/355253227965999. 350290617966018/355253227966013. 350290617966026/355253227966021. 350290617966034/35525322796603
9. 350290617966042/355253227966047. 350290617966059/355253227966054. 350290617966067/355253227966062. 350290617966075/35525322796
6070. 350290617966083/355253227966088. 350290617966091/355253227966096. 350290617966109/355253227966104. 350290617966117/35525322
7966112. 350290617966125/355253227966120. 350290617966133/355253227966138. 350290617966158/355253227966153. 350290617966166/35525
3227966161. 350290617966174/355253227966179. 350290617966182/355253227966187. 350290617966190/355253227966195.350290617966208/355
253227966203. 350290617966216/355253227966211. 350290617966224/355253227966229. 350290617966232/355253227966237. 350290617966240/
355253227966245. 350290617966257/355253227966252. 350290617966265/355253227966260. 350290617966273/355253227966278. 3502906179662
81/355253227966286. 350290617966299/355253227966294. 350290617966307/355253227966302. 350290617966315/355253227966310. 3502906179
66323/355253227966328. 350290617966331/355253227966336. 350290617966349/355253227966344. 350290617966356/355253227966351. 3502906
17966364/355253227966369.350290617966372/355253227966377. 350290617966380/355253227966385. 350290617966398/355253227966393. 35029
0617966406/355253227966401. 350290617966414/355253227966419. 350290617966422/355253227966427. 350290617966430/355253227966435. 35
0290617966448/355253227966443. 350290617966455/355253227966450. 350290617966463/355253227966468. 350290617966471/355253227966476.
350290617966497/355253227966492. 350290617966505/355253227966500. 350290617966513/355253227966518. 350290617966521/3552532279665
26. 350290617966539/355253227966534. 350290617966547/355253227966542. 350290617966554/355253227966559. 350290617966562/3552532279
66567. 350290617966570/355253227966575. 350290617966588/355253227966583. 350290617966596/355253227966591. 350290617966604/3552532
27966609. 350290617966620/355253227966625. 350290617966646/355253227966641. 350290617966661/355253227966666. 350290617966729/3552
53227966724. 350290617966745/355253227966740. 350290617966786/355253227966781. 350290617966802/355253227966807. 350290617966810/3
55253227966815. 350290617966828/355253227966823. 350290617966836/355253227966831. 350290617966877/355253227966872. 35029061796688
5/355253227966880. 350290617966901/355253227966906. 350290617966919/355253227966914. 350290617966927/355253227966922. 35029061796
6935/355253227966930. 350290617966943/355253227966948. 350290617966968/355253227966963. 350290617966976/355253227966971. 35029061
7966984/355253227966989. 350290617966992/355253227966997. 350290617967008/355253227967003. 350290617967016/355253227967011. 35029
0617967040/355253227967045. 350290617967057/355253227967052. 350290617967065/355253227967060. 350290617967073/355253227967078. 35
0290617967081/355253227967086. 350290617967099/355253227967094. 350290617967107/355253227967102.350290617967115/355253227967110.
350290617967123/355253227967128. 350290617967131/355253227967136. 350290617967149/355253227967144. 350290617967610/35525322796761
5. 350290617967628/355253227967623. 350290617967636/355253227967631. 350290617967644/355253227967649. 350290617967651/35525322796
7656. 350290617967669/355253227967664. 350290617967677/355253227967672. 350290617967685/355253227967680. 350290617967693/35525322
7967698. 350290617967701/355253227967706. 350290617967719/355253227967714. 350290617967727/355253227967722. 350290617967735/35525
3227967730.350290617967743/355253227967748. 350290617967750/355253227967755. 350290617967768/355253227967763. 350290617967776/355
253227967771. 350290617967792/355253227967797. 350290617967800/355253227967805. 350290617967826/355253227967821. 350290617967834/
355253227967839. 350290617967842/355253227967847. 350290617967859/355253227967854. 350290617967867/355253227967862. 3502906179678
83/355253227967888. 350290617967925/355253227967920. 350290617967958/355253227967953. 350290617967966/355253227967961. 3502906179
68006/355253227968001. 350290617968014/355253227968019. 350290617968022/355253227968027. 350290617968030/355253227968035. 3502906
17968048/355253227968043. 350290617968055/355253227968050. 350290617968063/355253227968068. 350290617968097/355253227968092. 3502
90617968113/355253227968118. 350290617968154/355253227968159. 350290617968170/355253227968175. 350290617968188/355253227968183. 3
50290617968212/355253227968217. 350290617968220/355253227968225. 350290617968253/355253227968258. 350290617968261/355253227968266
. 350290617968279/355253227968274. 350290617968287/355253227968282. 350290617969442/355253227969447. 350290617969459/355253227969
454. 350290617969467/355253227969462. 350290617969475/355253227969470. 350290617969483/355253227969488. 350290617969491/355253227
969496. 350290617969509/355253227969504. 350290617969517/355253227969512. 350290617969525/355253227969520. 350290617969533/355253
227969538. 350290617969541/355253227969546. 350290617969566/355253227969561. 350290617969582/355253227969587. 350290617969590/355
253227969595. 350290617969608/355253227969603. 350290617969624/355253227969629. 350290617969632/355253227969637. 350290617969640/
355253227969645. 350290617969657/355253227969652. 350290617969665/355253227969660.350290617969673/355253227969678. 35029061796969
9/355253227969694. 350290617969707/355253227969702. 350290617969715/355253227969710. 350290617969723/355253227969728. 35029061796
9731/355253227969736. 350290617969764/355253227969769. 350290617969772/355253227969777. 350290617969780/355253227969785. 35029061
7969798/355253227969793. 350290617969814/355253227969819. 350290617969822/355253227969827. 350290617968295/355253227968290. 35029
0617968303/355253227968308. 350290617968329/355253227968324. 350290617968337/355253227968332. 350290617968352/355253227968357.350
290617968378/355253227968373. 350290617968386/355253227968381. 350290617968436/355253227968431. 350290617968444/355253227968449.
350290617968485/355253227968480. 350290617968527/355253227968522. 350290617968535/355253227968530. 350290617968543/35525322796854
8. 350290617968550/355253227968555. 350290617968568/355253227968563. 350290617968576/355253227968571. 350290617968584/35525322796
8589. 350290617968600/355253227968605. 350290617968618/355253227968613. 350290617968626/355253227968621. 350290617968634/35525322
7968639. 350290617968642/355253227968647. 350290617968659/355253227968654. 350290617968675/355253227968670. 350290617968691/35525
3227968696. 350290617968709/355253227968704. 350290617968717/355253227968712. 350290617968725/355253227968720. 350290617968733/35
032024001257512-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001257512-5 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
5253227968738. 350290617968758/355253227968753. 350290617968774/355253227968779. 350290617968782/355253227968787. 350290617968816
/355253227968811. 350290617968824/355253227968829. 350290617968840/355253227968845. 350290617968857/355253227968852. 350290617968
865/355253227968860. 350290617968873/355253227968878. 350290617968881/355253227968886. 350290617968899/355253227968894. 350290617
968907/355253227968902. 350290617968915/355253227968910. 350290617968923/355253227968928. 350290617968931/355253227968936. 350290
617968949/355253227968944. 350290617968956/355253227968951. 350290617967156/355253227967151. 350290617967164/355253227967169. 350
290617967172/355253227967177. 350290617967180/355253227967185. 350290617967198/355253227967193. 350290617967206/355253227967201.
350290617967214/355253227967219. 350290617967222/355253227967227. 350290617967230/355253227967235. 350290617967248/35525322796724
3. 350290617967255/355253227967250. 350290617967263/355253227967268.350290617967271/355253227967276. 350290617967289/355253227967
284. 350290617967297/355253227967292. 350290617967305/355253227967300. 350290617967313/355253227967318. 350290617967321/355253227
967326. 350290617967339/355253227967334. 350290617967347/355253227967342. 350290617967354/355253227967359. 350290617967362/355253
227967367. 350290617967370/355253227967375. 350290617967388/355253227967383. 350290617967396/355253227967391. 350290617967404/355
253227967409. 350290617967412/355253227967417. 350290617967420/355253227967425. 350290617967438/355253227967433.350290617967446/3
55253227967441. 350290617967453/355253227967458. 350290617967461/355253227967466. 350290617967479/355253227967474. 35029061796748
7/355253227967482. 350290617967495/355253227967490. 350290617967503/355253227967508. 350290617967511/355253227967516. 35029061796
7529/355253227967524. 350290617967537/355253227967532. 350290617967545/355253227967540. 350290617967552/355253227967557. 35029061
7967560/355253227967565. 350290617967578/355253227967573. 350290617967586/355253227967581. 350290617967594/355253227967599. 35029
0617967602/355253227967607. 350290617968964/355253227968969. 350290617968972/355253227968977. 350290617968980/355253227968985. 35
0290617968998/355253227968993. 350290617969004/355253227969009. 350290617969012/355253227969017. 350290617969020/355253227969025.
350290617969038/355253227969033. 350290617969046/355253227969041. 350290617969053/355253227969058. 350290617969061/3552532279690
66. 350290617969079/355253227969074. 350290617969087/355253227969082. 350290617969095/355253227969090. 350290617969103/3552532279
69108. 350290617969111/355253227969116. 350290617969129/355253227969124. 350290617969137/355253227969132. 350290617969145/3552532
27969140. 350290617969152/355253227969157. 350290617969178/355253227969173. 350290617969186/355253227969181. 350290617969194/3552
53227969199. 350290617969202/355253227969207. 350290617969210/355253227969215. 350290617969236/355253227969231. 350290617969244/3
55253227969249. 350290617969251/355253227969256. 350290617969269/355253227969264. 350290617969277/355253227969272. 35029061796928
5/355253227969280. 350290617969293/355253227969298. 350290617969301/355253227969306. 350290617969319/355253227969314. 35029061796
9327/355253227969322. 350290617969335/355253227969330.350290617969343/355253227969348. 350290617969350/355253227969355. 350290617
969368/355253227969363. 350290617969376/355253227969371. 350290617969384/355253227969389. 350290617969392/355253227969397. 350290
617969400/355253227969405. 350290617969418/355253227969413. 350290617969426/355253227969421. 350290617969434/355253227969439XXXXX
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032024001257512-5
Espacio para uso exclusivo de la Entidad Recaudadora
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