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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
032024001277117-4
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 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. 116575014777943 2024 – 09 – 15 No. SHAN0342068 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 9102864615 2024 – 09 – 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.
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
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
157.00
500.00
78 .Valor FOB 79 . Valor fletes USD USD
49.415.54
1.125.69
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
2.45
0
Arancel
0
0
0.00
92 93 94 0.00 210.893.505
95
96
I.V.A.
9798 99 100 101
0.00 210.893.505 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.128.14
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
50.543.68
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: 530698-DECL: 1838841-DO: 893121267241- 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: 3072683473. ID CONTENEDOR: 6077885340. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A155MLBILTC, 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 Estado de levante: Levante automático
No hay declaración posterior
131 . Espacio reservado uso exclusivo Ministerio de Relaciones Exteriores
132 . No. Aceptación declaración 032024001277117
133. Feha: 202409 13
134 . Levante No. 032024001204446 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 16
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 92032406848456
Fecha presentación 2024-09-13 20:43:32 Valor pagado $0.00
Fecha de Impresión: 2024-09-16 13:05:39
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001277117-4 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. 500,00 u
)(500,00 PCE); IMEIS: 355170561189855/355533001189852. 355170561189954/355533001189951. 355170561190044/355533001190041. 3551705
61190069/355533001190066. 355170561190077/355533001190074. 355170561190150/355533001190157. 355170561190168/355533001190165. 3551
70561190200/355533001190207. 355170561190218/355533001190215. 355170561190267/355533001190264. 355170561190309/355533001190306. 3
55170561190671/355533001190678. 355170561190705/355533001190702. 355170561190754/355533001190751. 355170561190762/355533001190769
. 355170561190804/355533001190801. 355170561190820/355533001190827. 355170561190838/355533001190835. 355170561190846/355533001190
843. 355170561190903/355533001190900. 355170561190929/355533001190926. 355170561191059/355533001191056. 355170561191455/355533001
191452. 355170561191513/355533001191510. 355170561191604/355533001191601. 355170561191661/3 55533001191668. 355170561191729/35553
3001191726. 355170561192081/355533001192088. 355170561192180/355533001192187. 355170561192214/355533001192211. 355170561192255/35
5533001192252. 355170561192263/355533001192260. 355170561192289/355533001192286. 355170561192479/355533001192476.355170561192867/
355533001192864. 355170561193006/355533001193003. 355170561193105/355533001193102. 355170561193139/355533001193136. 3551705611931
54/355533001193151. 355170561193212/355533001193219. 355170561193238/355533001193235. 355170561193246/355533001193243. 3551705611
93295/355533001193292. 355170561193329/355533001193326. 355170561193337/355533001193334. 355170561193345/355533001193342. 3551705
61193352/355533001193359. 355170561193378/355533001193375. 355170561193394/355533001193391. 355170561193402/355533001193409. 3551
70561193410/355533001193417.355170561193436/355533001193433. 355170561193451/355533001193458. 355170561193519/355533001193516. 35
5170561193527/355533001193524. 355170561193568/355533001193565. 355170561193576/355533001193573. 355170561193600/355533001193607.
355170561193618/355533001193615. 355170561193626/355533001193623. 355170561193725/355533001193722. 355170561194210/3555330011942
17. 355170561194376/355533001194373. 355170561194673/355533001194670. 355170561194731/355533001194738. 355170561194772/3555330011
94779. 355170561194830/355533001194837. 355170561195068/355533001195065. 355170561195084/355533001195081. 355170561195175/3555330
01195172. 355170561195258/355533001195255. 355170561195274/355533001195271. 355170561195324/355533001195321. 355170561195357/3555
33001195354. 355170561195399/355533001195396. 355170561195415/355533001195412. 355170561195431/355533001195438. 355170561195449/3
55533001195446. 355170561195456/355533001195453. 355170561195464/355533001195461. 355170561195472/355533001195479. 35517056119548
0/355533001195487. 355170561195498/355533001195495. 355170561195514/355533001195511. 355170561195522/355533001195529. 35517056119
5530/355533001195537. 355170561195548/355533001195545. 355170561195555/355533001195552. 355170561195639/355533001195636. 35517056
1195654/355533001195651. 355170561195662/355533001195669. 355170561195670/355533001195677. 355170561195704/355533001195701. 35517
0561195712/355533001195719. 355170561195720/355533001195727. 355170561195811/355533001195818. 355170561196769/355533001196766. 35
5170561197023/355533001197020. 355170561197072/355533001197079. 355170561197148/355533001197145. 355170561197346/355533001197343.
355170561197387/355533001197384. 355170561197395/355533001197392. 355170561197411/355533001197418.355170561197429/35553300119742
6. 355170561197478/355533001197475. 355170561197502/355533001197509. 355170561197544/355533001197541. 355170561197551/35553300119
7558. 355170561197569/355533001197566. 355170561197601/355533001197608. 355170561197627/355533001197624. 355170561197635/35553300
1197632. 355170561197668/355533001197665. 355170561197742/355533001197749. 355170561197957/355533001197954. 355170561197965/35553
3001197962. 355170561198088/355533001198085. 355170561198096/355533001198093. 355170561198112/355533001198119. 355170561198245/35
5533001198242.355170561198252/355533001198259. 355170561198260/355533001198267. 355170561198278/355533001198275. 355170561198286/
355533001198283. 355170561198294/355533001198291. 355170561198302/355533001198309. 355170561198310/355533001198317. 3551705611983
28/355533001198325. 355170561198344/355533001198341. 355170561198369/355533001198366. 355170561198419/355533001198416. 3551705611
98468/355533001198465. 355170561198542/355533001198549. 355170561198567/355533001198564. 355170561198583/355533001198580. 3551705
61198591/355533001198598. 355170561198633/355533001198630. 355170561198641/355533001198648. 355170561198773/355533001198770. 3551
70561198781/355533001198788. 355170561198831/355533001198838. 355170561198880/355533001198887. 355170561199078/355533001199075. 3
55170561199748/355533001199745. 355170561199771/355533001199778. 355170561199789/355533001199786. 355170561199805/355533001199802
. 355170561199888/355533001199885. 355170561200306/355533001200303. 355170561200363/355533001200360. 355170561200397/355533001200
394. 355170561200405/355533001200402. 355170561200413/355533001200410. 355170561200603/355533001200600. 355170561200637/355533001
200634. 355170561200736/355533001200733. 355170561200751/355533001200758. 355170561200769/355533001200766. 355170561200785/355533
001200782. 355170561200819/355533001200816. 355170561200827/355533001200824. 355170561200835/355533001200832. 355170561200850/355
533001200857. 355170561200868/355533001200865. 355170561200884/355533001200881. 355170561200900/355533001200907. 355170561200926/
355533001200923. 355170561200934/355533001200931. 355170561200942/355533001200949. 355170561200975/355533001200972. 3551705612009
83/355533001200980. 355170561200991/355533001200998. 355170561201015/355533001201012.355170561201049/355533001201046. 35517056120
1080/355533001201087. 355170561201106/355533001201103. 355170561201114/355533001201111. 355170561201155/355533001201152. 35517056
1201171/355533001201178. 355170561201296/355533001201293. 355170561201353/355533001201350. 355170561201361/355533001201368. 35517
0561201379/355533001201376. 355170561201387/355533001201384. 355170561201403/355533001201400. 355170561201700/355533001201707. 35
5170561201791/355533001201798. 355170561201809/355533001201806. 355170561201833/355533001201830. 355170561201932/355533001201939.
355170561202187/355533001202184. 355170561202245/355533001202242. 355170561202427/355533001202424. 355170561202492/35553300120249
9. 355170561202583/355533001202580. 355170561202591/355533001202598. 355170561202609/355533001202606. 355170561202617/35553300120
2614. 355170561202625/355533001202622. 355170561202633/355533001202630. 355170561202658/355533001202655. 355170561202674/35553300
1202671. 355170561202708/355533001202705. 355170561202724/355533001202721. 355170561202757/355533001202754. 355170561202773/35553
3001202770. 355170561202807/355533001202804. 355170561202815/355533001202812. 355170561202823/355533001202820. 355170561202831/35
5533001202838. 355170561202864/355533001202861. 355170561202914/355533001202911. 355170561203102/355533001203109. 355170561203169
/355533001203166. 355170561203227/355533001203224. 355170561203235/355533001203232. 355170561203375/355533001203372. 355170561203
466/355533001203463. 355170561203482/355533001203489. 355170561203599/355533001203596. 355170561203714/355533001203711. 355170561
203748/355533001203745. 355170561207947/355533001207944. 355170561207954/355533001207951. 355170561207962/355533001207969. 355170
561207988/355533001207985. 355170561207996/355533001207993. 355170561208028/355533001208025. 355170561208077/355533001208074. 355
170561208119/355533001208116. 355170561208176/355533001208173. 355170561208267/355533001208264. 355170561208416/355533001208413.
355170561208481/355533001208488. 355170561208507/355533001208504. 355170561208556/355533001208553. 355170561208671/35553300120867
8. 355170561208754/355533001208751. 355170561208770/355533001208777. 355170561208804/355533001208801. 355170561208812/35553300120
8819. 355170561208846/355533001208843. 355170561208853/355533001208850.355170561208861/355533001208868. 355170561208903/355533001
208900. 355170561208929/355533001208926. 355170561208978/355533001208975. 355170561208986/355533001208983. 355170561209000/355533
001209007. 355170561209026/355533001209023. 355170561209034/355533001209031. 355170561209042/355533001209049. 355170561209075/355
533001209072. 355170561209091/355533001209098. 355170561209117/355533001209114. 355170561209166/355533001209163. 355170561209208/
355533001209205. 355170561209331/355533001209338. 355170561209570/355533001209577. 355170561209596/355533001209593.35517056120960
4/355533001209601. 355170561209638/355533001209635. 355170561209935/355533001209932. 355170561210099/355533001210096. 35517056121
0115/355533001210112. 355170561210511/355533001210518. 355170561203763/355533001203760. 355170561203839/355533001203836. 35517056
1203854/355533001203851. 355170561203862/355533001203869. 355170561203870/355533001203877. 355170561203904/355533001203901. 35517
0561203912/355533001203919. 355170561203920/355533001203927. 355170561203953/355533001203950. 355170561203995/355533001203992. 35
5170561204019/355533001204016. 355170561204043/355533001204040. 355170561204084/355533001204081. 355170561204100/355533001204107.
355170561204118/355533001204115. 355170561204134/355533001204131. 355170561204142/355533001204149. 355170561204159/3555330012041
56. 355170561204175/355533001204172. 355170561204191/355533001204198. 355170561204217/355533001204214. 355170561204548/3555330012
032024001277117-4
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001277117-4 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
04545. 355170561204845/355533001204842. 355170561204860/355533001204867. 355170561204878/355533001204875. 355170561204886/3555330
01204883. 355170561205081/355533001205088. 355170561205156/355533001205153. 355170561205172/355533001205179. 355170561205198/3555
33001205195. 355170561205206/355533001205203. 355170561205214/355533001205211. 355170561205230/355533001205237. 355170561205586/3
55533001205583. 355170561205636/355533001205633. 355170561205669/355533001205666. 355170561205719/355533001205716. 35517056120581
8/355533001205815. 355170561205958/355533001205955. 355170561205974/355533001205971. 355170561206014/355533001206011. 35517056120
6030/355533001206037. 355170561206089/355533001206086. 355170561206105/355533001206102. 355170561206147/355533001206144. 35517056
1206162/355533001206169. 355170561206188/355533001206185.355170561206212/355533001206219. 355170561206238/355533001206235. 355170
561206253/355533001206250. 355170561206261/355533001206268. 355170561206303/355533001206300. 355170561206337/355533001206334. 355
170561206345/355533001206342. 355170561206352/355533001206359. 355170561206378/355533001206375. 355170561206386/355533001206383.
355170561206402/355533001206409. 355170561206428/355533001206425. 355170561206444/355533001206441. 355170561206451/35553300120645
8. 355170561206469/355533001206466. 355170561206485/355533001206482. 355170561206493/355533001206490.355170561206527/355533001206
524. 355170561206550/355533001206557. 355170561206568/355533001206565. 355170561206600/355533001206607. 355170561206626/355533001
206623. 355170561206659/355533001206656. 355170561206667/355533001206664. 355170561206675/355533001206672. 355170561206683/355533
001206680. 355170561206691/355533001206698. 355170561206709/355533001206706. 355170561206717/355533001206714. 355170561206725/355
533001206722. 355170561206899/355533001206896. 355170561207244/355533001207241. 355170561207319/355533001207316. 355170561207376/
355533001207373. 355170561207418/355533001207415. 355170561207640/355533001207647. 355170561207681/355533001207688. 3551705612077
15/355533001207712. 355170561207798/355533001207795. 355170561207830/355533001207837. 355170561207871/355533001207878. 3551705612
07921/355533001207928. 355170561210693/355533001210690. 355170561211543/355533001211540. 355170561211790/355533001211797. 3551705
61211857/355533001211854. 355170561212178/355533001212175. 355170561212863/355533001212860. 355170561214398/355533001214395. 3551
70561214430/355533001214437. 355170561214497/355533001214494. 355170561214521/355533001214528. 355170561214604/355533001214601. 3
55170561181209/355533001181206. 355170561181225/355533001181222. 355170561181266/355533001181263. 355170561181282/355533001181289
. 355170561181290/355533001181297. 355170561181332/355533001181339. 355170561181340/355533001181347. 355170561181365/355533001181
362. 355170561181381/355533001181388. 355170561181399/355533001181396. 355170561181407/355533001181404. 355170561181415/355533001
181412. 355170561181431/355533001181438. 355170561181456/355533001181453. 355170561181472/355533001181479. 355170561181480/355533
001181487. 355170561181514/355533001181511.355170561181530/355533001181537. 355170561181555/355533001181552. 355170561181563/3555
33001181560. 355170561181589/355533001181586. 355170561181597/355533001181594. 355170561181605/355533001181602. 355170561181621/3
55533001181628. 355170561181639/355533001181636. 355170561181647/355533001181644. 355170561181654/355533001181651. 35517056118166
2/355533001181669. 355170561181738/355533001181735. 355170561181753/355533001181750. 355170561181761/355533001181768. 35517056118
1803/355533001181800. 355170561181829/355533001181826. 355170561181837/355533001181834.355170561181878/355533001181875. 355170561
181886/355533001181883. 355170561181894/355533001181891. 355170561181902/355533001181909. 355170561181944/355533001181941. 355170
561182033/355533001182030. 355170561182041/355533001182048. 355170561182058/355533001182055. 355170561182173/355533001182170. 355
170561182256/355533001182253. 355170561182355/355533001182352. 355170561182496/355533001182493. 355170561182595/355533001182592.
355170561182660/355533001182667. 355170561182785/355533001182782. 355170561182793/355533001182790. 355170561182827/35553300118282
4. 355170561182868/355533001182865. 355170561182892/355533001182899. 355170561182900/355533001182907. 355170561182918/35553300118
2915. 355170561182967/355533001182964. 355170561183007/355533001183004. 355170561183015/355533001183012. 355170561183023/35553300
1183020. 355170561183031/355533001183038. 355170561183049/355533001183046. 355170561183064/355533001183061. 355170561183114/35553
3001183111. 355170561183122/355533001183129. 355170561183155/355533001183152. 355170561183163/355533001183160. 355170561183171/35
5533001183178. 355170561184013/355533001184010. 355170561184039/355533001184036. 355170561184047/355533001184044. 355170561184062
/355533001184069. 355170561184070/355533001184077. 355170561184096/355533001184093. 355170561184112/355533001184119. 355170561184
120/355533001184127. 355170561184146/355533001184143. 355170561184153/355533001184150. 355170561184161/355533001184168. 355170561
184179/355533001184176. 355170561184757/355533001184754. 355170561184807/355533001184804. 355170561185127/355533001185124. 355170
561185184/355533001185181. 355170561185473/355533001185470. 355170561186307/355533001186304. 355170561186935/355533001186932. 355
170561187040/355533001187047.355170561187610/355533001187617. 355170561187628/355533001187625. 355170561187669/355533001187666. 3
55170561188162/355533001188169. 355170561188212/355533001188219. 355170561188261/355533001188268. 355170561188444/355533001188441
. 355170561188469/355533001188466. 355170561188519/355533001188516. 355170561188584/355533001188581. 355170561188808/355533001188
805. 355170561188857/355533001188854. 355170561188915/355533001188912. 355170561189012/355533001189019. 355170561189053/355533001
189050. 355170561189061/355533001189068. 355170561189095/355533001189092.355170561189111/355533001189118. 355170561189129/3555330
01189126. 355170561189145/355533001189142. 355170561189160/355533001189167. 355170561189202/355533001189209. 355170561189269/3555
33001189266. 355170561189319/355533001189316. 355170561189335/355533001189332. 355170561189343/355533001189340. 355170561189350/3
55533001189357. 355170561189368/355533001189365. 355170561189384/355533001189381. 355170561189392/355533001189399. 35517056118940
0/355533001189407. 355170561189459/355533001189456. 355170561189467/355533001189464. 355170561189491/355533001189498. 35517056118
9566/355533001189563. 355170561189616/355533001189613. 355170561189632/355533001189639. 355170561189640/355533001189647. 35517056
1189665/355533001189662. 355170561189715/355533001189712. 355170561189731/355533001189738. 355170561189756/355533001189753. 35517
0561189764/355533001189761. 355170561189772/355533001189779. 355170561189798/355533001189795. 355170561189806/355533001189803XXXX
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032024001277117-4
Espacio para uso exclusivo de la Entidad Recaudadora
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