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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
032024001151337-6
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. 116575014686211 2024 – 08 – 21 No. KHAN24087007 2024 – 08 – 16
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 9102811614 2024 – 08 – 15 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.
4.014.18
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 112.00 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
143.00
400.00
78 .Valor FOB 79 . Valor fletes USD USD
70.169.44
1.025.31
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
3.45
0
Arancel
0
0
0.00
92 93 94 0.00 285.802.390
95
96
I.V.A.
9798 99 100 101
0.00 285.802.390 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.028.76
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
71.198.20
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: 527772-DECL: 1831495-DO: 893119029241- 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: 3071679894. ID CONTENEDOR: 6077467289. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A356EZKGLTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A35 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO(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 032024001151337
133. Feha: 202408 22
134 . Levante No. 032024001081531 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 08 – 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 92032406202144
Fecha presentación 2024-08-22 13:57:51 Valor pagado $0.00
Fecha de Impresión: 2024-08-22 13:58:19
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001151337-6 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
, MODELO: SM-A356E/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A356E/DS,BLACK,LTC( QTY. 400,00 u )(400,00 PC
E); IMEIS: 351676562503344/357896812503340. 351676562503674/357896812503670. 351676562503781/357896812503787. 351676562534992/357
896812534998. 351676562535007/357896812535003. 351676562535056/357896812535052. 351676562535098/357896812535094. 351676562535304/
357896812535300. 351676562535312/357896812535318. 351676562535338/357896812535334. 351676562535379/357896812535375. 3516765625353
87/357896812535383. 351676562535403/357896812535409. 351676562535510/357896812535516. 351676562538852/357896812538858. 3516765625
38928/357896812538924. 351676562539645/357896812539641. 351676562539678/357896812539674. 351676562539686/357896812539682. 3516765
62539728/357896812539724. 351676562539736/357896812539732. 351676562539744/357896812539740. 351676562539751/357896812539757. 3516
76562539769/357896812539765. 351676562539777/357896812539773. 351676562539801/35789681253980 7. 351676562539835/357896812539831.
351676562540130/357896812540136. 351676562540221/357896812540227. 351676562540270/357896812540276. 351676562540296/35789681254029
2. 351676562540312/357896812540318. 351676562540361/357896812540367. 351676562540379/357896812540375. 351676562540387/35789681254
0383. 351676562540429/357896812540425. 351676562540445/357896812540441. 351676562540452/357896812540458. 351676562540478/35789681
2540474. 351676562540486/357896812540482. 351676562540510/357896812540516. 351676562540528/357896812540524. 351676562540551/35789
6812540557. 351676562540569/357896812540565. 351676562498578/357896812498574.351676562498610/357896812498616. 351676562498651/357
896812498657. 351676562498669/357896812498665. 351676562498677/357896812498673. 351676562498685/357896812498681. 351676562498727/
357896812498723. 351676562498735/357896812498731. 351676562498743/357896812498749. 351676562498750/357896812498756. 3516765624988
18/357896812498814. 351676562498826/357896812498822. 351676562499113/357896812499119. 351676562499246/357896812499242. 3516765624
99832/357896812499838. 351676562499873/357896812499879. 351676562499899/357896812499895. 351676562499907/357896812499903.35167656
2499931/357896812499937. 351676562499972/357896812499978. 351676562500043/357896812500049. 351676562500282/357896812500288. 35167
6562500605/357896812500601. 351676562500977/357896812500973. 351676562501066/357896812501062. 351676562501165/357896812501161. 35
1676562501462/357896812501468. 351676562501488/357896812501484. 351676562501918/357896812501914. 351676562502080/357896812502086.
351676562502114/357896812502110. 351676562502171/357896812502177. 351676562502239/357896812502235. 351676562502247/3578968125022
43. 351676562502254/357896812502250. 351676562502262/357896812502268. 351676562502304/357896812502300. 351676562502312/3578968125
02318. 351676562502353/357896812502359. 351676562502361/357896812502367. 351676562502395/357896812502391. 351676562502932/3578968
12502938. 351676562502957/357896812502953. 351676562503138/357896812503134. 351676562540577/357896812540573. 351676562540593/3578
96812540599. 351676562540601/357896812540607. 351676562540619/357896812540615. 351676562540643/357896812540649. 351676562540676/3
57896812540672. 351676562540684/357896812540680. 351676562540759/357896812540755. 351676562540783/357896812540789. 35167656254081
7/357896812540813. 351676562540825/357896812540821. 351676562540973/357896812540979. 351676562541096/357896812541092. 35167656254
1971/357896812541977. 351676562543175/357896812543171. 351676562543258/357896812543254. 351676562543274/357896812543270. 35167656
2543282/357896812543288. 351676562543290/357896812543296. 351676562543308/357896812543304. 351676562543324/357896812543320. 35167
6562543340/357896812543346. 351676562543357/357896812543353. 351676562543365/357896812543361. 351676562543373/357896812543379. 35
1676562543381/357896812543387. 351676562543399/357896812543395.351676562543407/357896812543403. 351676562543415/357896812543411.
351676562543449/357896812543445. 351676562543456/357896812543452. 351676562543464/357896812543460. 351676562543472/35789681254347
8. 351676562543480/357896812543486. 351676562543498/357896812543494. 351676562543506/357896812543502. 351676562543514/35789681254
3510. 351676562543522/357896812543528. 351676562543530/357896812543536. 351676562543548/357896812543544. 351676562543555/35789681
2543551. 351676562543563/357896812543569. 351676562543571/357896812543577. 351676562543589/357896812543585.351676562543597/357896
812543593. 351676562543613/357896812543619. 351676562543647/357896812543643. 351676562544504/357896812544500. 351676562544777/357
896812544773. 351676562544843/357896812544849. 351676562544918/357896812544914. 351676562544942/357896812544948. 351676562544959/
357896812544955. 351676562544975/357896812544971. 351676562544991/357896812544997. 351676562545014/357896812545010. 3516765625450
22/357896812545028. 351676562545097/357896812545093. 351676562545204/357896812545200. 351676562547481/357896812547487. 3516765625
47499/357896812547495. 351676562547523/357896812547529. 351676562547549/357896812547545. 351676562547580/357896812547586. 3516765
62547614/357896812547610. 351676562547663/357896812547669. 351676562548760/357896812548766. 351676562551483/357896812551489. 3516
76562551541/357896812551547. 351676562551558/357896812551554. 351676562551574/357896812551570. 351676562551582/357896812551588. 3
51676562551590/357896812551596. 351676562551723/357896812551729. 351676562551749/357896812551745. 351676562551863/357896812551869
. 351676562551921/357896812551927. 351676562551996/357896812551992. 351676562552010/357896812552016. 351676562552028/357896812552
024. 351676562552036/357896812552032. 351676562552069/357896812552065. 351676562552085/357896812552081. 351676562552093/357896812
552099. 351676562552119/357896812552115. 351676562552143/357896812552149. 351676562552168/357896812552164. 351676562552176/357896
812552172. 351676562552192/357896812552198. 351676562552200/357896812552206. 351676562552218/357896812552214. 351676562552226/357
896812552222. 351676562552234/357896812552230. 351676562552267/357896812552263. 351676562552275/357896812552271. 351676562552291/
357896812552297. 351676562552333/357896812552339.351676562552358/357896812552354. 351676562552366/357896812552362. 35167656255241
6/357896812552412. 351676562553463/357896812553469. 351676562555252/357896812555258. 351676562556136/357896812556132. 35167656255
6250/357896812556256. 351676562556367/357896812556363. 351676562556672/357896812556678. 351676562556912/357896812556918. 35167656
2556979/357896812556975. 351676562557316/357896812557312. 351676562557332/357896812557338. 351676562557399/357896812557395. 35167
6562557407/357896812557403. 351676562557456/357896812557452. 351676562557795/357896812557791.351676562557803/357896812557809. 351
676562557811/357896812557817. 351676562557829/357896812557825. 351676562557845/357896812557841. 351676562557852/357896812557858.
351676562557860/357896812557866. 351676562557878/357896812557874. 351676562557886/357896812557882. 351676562557894/35789681255789
0. 351676562557910/357896812557916. 351676562557944/357896812557940. 351676562557969/357896812557965. 351676562558090/35789681255
8096. 351676562558116/357896812558112. 351676562558124/357896812558120. 351676562558140/357896812558146. 351676562558157/35789681
2558153. 351676562558264/357896812558260. 351676562558330/357896812558336. 351676562558371/357896812558377. 351676562558397/35789
6812558393. 351676562558413/357896812558419. 351676562558447/357896812558443. 351676562558454/357896812558450. 351676562558470/35
7896812558476. 351676562558488/357896812558484. 351676562558496/357896812558492. 351676562558561/357896812558567. 351676562558579
/357896812558575. 351676562560179/357896812560175. 351676562560377/357896812560373. 351676562561300/357896812561306. 351676562561
474/357896812561470. 351676562562076/357896812562072. 351676562562092/357896812562098. 351676562562118/357896812562114. 351676562
562126/357896812562122. 351676562562134/357896812562130. 351676562562522/357896812562528. 351676562562670/357896812562676. 351676
562562761/357896812562767. 351676562562951/357896812562957. 351676562562969/357896812562965. 351676562563033/357896812563039. 351
676562563074/357896812563070. 351676562563157/357896812563153. 351676562563280/357896812563286. 351676562563306/357896812563302.
351676562563314/357896812563310. 351676562563363/357896812563369. 351676562563397/357896812563393. 351676562563405/35789681256340
1. 351676562563413/357896812563419.351676562563421/357896812563427. 351676562563538/357896812563534. 351676562563785/357896812563
781. 351676562563793/357896812563799. 351676562563801/357896812563807. 351676562563819/357896812563815. 351676562563827/357896812
563823. 351676562563835/357896812563831. 351676562563843/357896812563849. 351676562563850/357896812563856. 351676562563868/357896
812563864. 351676562563900/357896812563906. 351676562563926/357896812563922. 351676562563934/357896812563930. 351676562563942/357
896812563948. 351676562563959/357896812563955. 351676562563967/357896812563963.351676562563975/357896812563971. 351676562563983/3
57896812563989. 351676562563991/357896812563997. 351676562564007/357896812564003. 351676562564015/357896812564011. 35167656256402
3/357896812564029. 351676562564031/357896812564037. 351676562564049/357896812564045. 351676562564056/357896812564052. 35167656256
4064/357896812564060. 351676562564072/357896812564078. 351676562564080/357896812564086. 351676562564106/357896812564102. 35167656
2564122/357896812564128. 351676562564130/357896812564136. 351676562564148/357896812564144. 351676562564155/357896812564151. 35167
032024001151337-6
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001151337-6 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
6562564163/357896812564169. 351676562564189/357896812564185. 351676562564205/357896812564201. 351676562564346/357896812564342. 35
1676562564437/357896812564433. 351676562564569/357896812564565. 351676562564577/357896812564573. 351676562564593/357896812564599.
351676562564601/357896812564607. 351676562564643/357896812564649. 351676562564668/357896812564664. 351676562564999/3578968125649
95. 351676562565004/357896812565000. 351676562565012/357896812565018. 351676562565046/357896812565042. 351676562565061/3578968125
65067. 351676562565079/357896812565075. 351676562565129/357896812565125. 351676562565145/357896812565141. 351676562565152/3578968
12565158. 351676562565178/357896812565174. 351676562565186/357896812565182. 351676562565202/357896812565208. 351676562565210/3578
96812565216. 351676562565251/357896812565257. 351676562565277/357896812565273. 351676562565574/357896812565570. 351676562565673/3
57896812565679. 351676562565772/357896812565778. 351676562565848/357896812565844. 351676562565855/357896812565851. 35167656256586
3/357896812565869. 351676562565871/357896812565877. 351676562565889/357896812565885. 351676562565897/357896812565893. 35167656256
5905/357896812565901.351676562565913/357896812565919. 351676562565921/357896812565927. 351676562565939/357896812565935. 351676562
565954/357896812565950. 351676562565970/357896812565976. 351676562565988/357896812565984. 351676562565996/357896812565992. 351676
562566002/357896812566008. 351676562566010/357896812566016. 351676562566028/357896812566024. 351676562566119/357896812566115. 351
676562566135/357896812566131. 351676562566143/357896812566149. 351676562566168/357896812566164. 351676562566184/357896812566180.
351676562566192/357896812566198. 351676562566226/357896812566222.351676562566572/357896812566578. 351676562566580/357896812566586
. 351676562566614/357896812566610. 351676562566622/357896812566628. 351676562566655/357896812566651. 351676562566663/357896812566
669. 351676562568461/357896812568467. 351676562568503/357896812568509. 351676562568545/357896812568541. 351676562568578/357896812
568574. 351676562568610/357896812568616. 351676562568651/357896812568657. 351676562569014/357896812569010. 351676562569055/357896
812569051. 351676562569071/357896812569077. 351676562569089/357896812569085. 351676562569113/357896812569119. 351676562569188/357
896812569184. 351676562569253/357896812569259. 351676562569261/357896812569267. 351676562569295/357896812569291. 351676562569329/
357896812569325. 351676562569337/357896812569333. 351676562569378/357896812569374. 351676562569535/357896812569531. 3516765625695
76/357896812569572. 351676562569584/357896812569580. 351676562569600/357896812569606. 351676562569626/357896812569622. 3516765625
69642/357896812569648. 351676562569667/357896812569663. 351676562569683/357896812569689. 351676562569691/357896812569697. 3516765
62569717/357896812569713. 351676562569766/357896812569762. 351676562570079/357896812570075. 351676562570178/357896812570174. 3516
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032024001151337-6
Espacio para uso exclusivo de la Entidad Recaudadora
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