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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
032024001230399-1
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. 116575014736123 2024 – 09 – 04 No. SHAN0342001 2024 – 08 – 31
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 9102850968 2024 – 08 – 31 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
580
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. DHL AERO EXPRESO S A SUCURSAL COLOMBIA
4.132.11
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
156.50
500.00
78 .Valor FOB 79 . Valor fletes USD USD
49.913.15
1.122.11
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
2.47
0
Arancel
0
0
0.00
92 93 94 0.00 210.893.515
95
96
I.V.A.
9798 99 100 101
0.00 210.893.515 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.124.58
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
51.037.73
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: 529525-DECL: 1836354-DO: 893120617241- 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: 3072686042. ID CONTENED
OR: 6077756383. MERCANCIA MARCA: SAMSUNGREFERENCIA: SM-A155MZKILTC, PRODUCTO: TELEFONO CELULAR GALAXY A15 5G DUOS, (CON ACCESORIO
S PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO,MODELO: SM-A155M/DSN, USO O DESTINO: PARA LA VENTA AL MAY(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 032024001230399
133. Feha: 202409 05
134 . Levante No. 032024001155472 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 05
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 92032406614160
Fecha presentación 2024-09-05 12:35:59 Valor pagado $0.00
Fecha de Impresión: 2024-09-05 12:36:05
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001230399-1 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
OR Y AL DETAL/ /MOBILE,SM-A155M/DSN,BLACK,LTC( QTY. 500,00 u )(500,00 PCE); IMEIS:355170561104235/355533001104232. 35517056110425
0/355533001104257. 355170561104276/355533001104273. 355170561104284/355533001104281. 355170561104318/355533001104315. 35517056110
4326/355533001104323. 355170561104359/355533001104356. 355170561104367/355533001104364. 355170561104375/355533001104372. 35517056
1104383/355533001104380. 355170561104417/355533001104414. 355170561104433/355533001104430. 355170561104441/355533001104448. 35517
0561104482/355533001104489. 355170561104516/355533001104513. 355170561104524/355533001104521. 355170561104532/355533001104539.355
170561104557/355533001104554. 355170561104565/355533001104562. 355170561104573/355533001104570. 355170561104599/355533001104596.
355170561104623/355533001104620. 355170561104631/355533001104638. 355170561104649/355533001104646. 355170561104698/35553300110469
5. 355170561104771/355533001104778. 355170561104805/355533001104802. 355170561104813/355 533001104810. 355170561104821/3555330011
04828. 355170561104839/355533001104836. 355170561104888/355533001104885. 355170561104904/355533001104901. 355170561104912/3555330
01104919. 355170561104987/355533001104984. 355170561104995/355533001104992. 355170561105000/355533001105007. 355170561105109/3555
33001105106. 355170561105117/355533001105114. 355170561105125/355533001105122. 355170561105141/355533001105148. 355170561105182/3
55533001105189. 355170561105190/355533001105197. 355170561105216/355533001105213. 355170561105224/355533001105221. 35517056110525
7/355533001105254. 355170561105273/355533001105270. 355170561146251/355533001146258. 355170561146293/355533001146290. 35517056114
6301/355533001146308. 355170561146350/355533001146357. 355170561146368/355533001146365. 355170561146418/355533001146415. 35517056
1146459/355533001146456. 355170561146467/355533001146464. 355170561146483/355533001146480. 355170560934913/355533000934910. 35517
0560938328/355533000938325. 355170560964654/355533000964651. 355170560964993/355533000964990. 355170560970917/355533000970914. 35
5170560979835/355533000979832. 355170560980296/355533000980293. 355170560982110/355533000982117. 355170560995435/355533000995432.
355170560996565/355533000996562. 355170560997829/355533000997826. 355170561056393/355533001056390. 355170561056807/3555330010568
04. 355170561057078/355533001057075. 355170561057094/355533001057091.355170561057128/355533001057125. 355170561057151/35553300105
7158. 355170561057177/355533001057174. 355170561057201/355533001057208. 355170561057219/355533001057216. 355170561057227/35553300
1057224. 355170561057235/355533001057232. 355170561057243/355533001057240. 355170561057326/355533001057323. 355170561057359/35553
3001057356. 355170561057763/355533001057760. 355170561057771/355533001057778. 355170561057797/355533001057794. 355170561057805/35
5533001057802. 355170561057813/355533001057810. 355170561057839/355533001057836. 355170561057854/355533001057851.355170561057862/
355533001057869. 355170561057870/355533001057877. 355170561057904/355533001057901. 355170561057920/355533001057927. 3551705610579
38/355533001057935. 355170561057953/355533001057950. 355170561057961/355533001057968. 355170561057979/355533001057976. 3551705610
57987/355533001057984. 355170561058035/355533001058032. 355170561058043/355533001058040. 355170561058068/355533001058065. 3551705
61058076/355533001058073. 355170561058092/355533001058099. 355170561058134/355533001058131. 355170561058159/355533001058156. 3551
70561058175/355533001058172. 355170561058191/355533001058198. 355170561058225/355533001058222. 355170561058274/355533001058271. 3
55170561058340/355533001058347. 355170561058357/355533001058354. 355170561058415/355533001058412. 355170561058423/355533001058420
. 355170561058480/355533001058487. 355170561058506/355533001058503. 355170561058548/355533001058545. 355170561058555/355533001058
552. 355170561058597/355533001058594. 355170561058654/355533001058651. 355170561059017/355533001059014. 355170561059405/355533001
059402. 355170561059413/355533001059410. 355170561059421/355533001059428. 355170561059462/355533001059469. 355170561059504/355533
001059501. 355170561059512/355533001059519. 355170561059629/355533001059626. 355170561059736/355533001059733. 355170561059744/355
533001059741. 355170561059777/355533001059774. 355170561059785/355533001059782. 355170561059827/355533001059824. 355170561059850/
355533001059857. 355170561059876/355533001059873. 355170561059884/355533001059881. 355170561059900/355533001059907. 3551705610599
18/355533001059915. 355170561059926/355533001059923. 355170561059975/355533001059972. 355170561059983/355533001059980. 3551705610
59991/355533001059998. 355170561060007/355533001060004.355170561060015/355533001060012. 355170561060023/355533001060020. 35517056
1060031/355533001060038. 355170561060049/355533001060046. 355170561060056/355533001060053. 355170561060072/355533001060079. 35517
0561060080/355533001060087. 355170561060106/355533001060103. 355170561060114/355533001060111. 355170561060122/355533001060129. 35
5170561060189/355533001060186. 355170561060205/355533001060202. 355170561060213/355533001060210. 355170561060221/355533001060228.
355170561060254/355533001060251. 355170561060262/355533001060269. 355170561060288/355533001060285.355170561060296/35553300106029
3. 355170561060312/355533001060319. 355170561060320/355533001060327. 355170561060338/355533001060335. 355170561060346/35553300106
0343. 355170561060353/355533001060350. 355170561060379/355533001060376. 355170561060395/355533001060392. 355170561060452/35553300
1060459. 355170561060478/355533001060475. 355170561060494/355533001060491. 355170561060510/355533001060517. 355170561060528/35553
3001060525. 355170561060536/355533001060533. 355170561060544/355533001060541. 355170561060551/355533001060558. 355170561060593/35
5533001060590. 355170561060601/355533001060608. 355170561060635/355533001060632. 355170561060643/355533001060640. 355170561060650
/355533001060657. 355170561060676/355533001060673. 355170561060726/355533001060723. 355170561060742/355533001060749. 355170561060
973/355533001060970. 355170561060981/355533001060988. 355170561060999/355533001060996. 355170561061005/355533001061002. 355170561
061013/355533001061010. 355170561061039/355533001061036. 355170561061047/355533001061044. 355170561061054/355533001061051. 355170
561061062/355533001061069. 355170561061088/355533001061085. 355170561061096/355533001061093. 355170561061104/355533001061101. 355
170561061153/355533001061150. 355170561061203/355533001061200. 355170561061229/355533001061226. 355170561061286/355533001061283.
355170561061294/355533001061291. 355170561061302/355533001061309. 355170561061310/355533001061317. 355170561061328/35553300106132
5. 355170561061336/355533001061333. 355170561061369/355533001061366. 355170561061377/355533001061374. 355170561061385/35553300106
1382. 355170561061419/355533001061416. 355170561061443/355533001061440. 355170561061468/355533001061465. 355170561061484/35553300
1061481. 355170561061492/355533001061499.355170561061542/355533001061549. 355170561061575/355533001061572. 355170561061583/355533
001061580. 355170561061633/355533001061630. 355170561061708/355533001061705. 355170561061716/355533001061713. 355170561061724/355
533001061721. 355170561061757/355533001061754. 355170561062250/355533001062257. 355170561062706/355533001062703. 355170561063183/
355533001063180. 355170561063340/355533001063347. 355170561063399/355533001063396. 355170561063407/355533001063404. 3551705610634
23/355533001063420. 355170561063431/355533001063438. 355170561066590/355533001066597.355170561067861/355533001067868. 35517056106
7960/355533001067967. 355170561068000/355533001068007. 355170561068018/355533001068015. 355170561068083/355533001068080. 35517056
1068091/355533001068098. 355170561068141/355533001068148. 355170561068190/355533001068197. 355170561068893/355533001068890. 35517
0561069297/355533001069294. 355170561071699/355533001071696. 355170561071897/355533001071894. 355170561073794/355533001073791. 35
5170561073802/355533001073809. 355170561073810/355533001073817. 355170561073828/355533001073825. 355170561073836/355533001073833.
355170561073844/355533001073841. 355170561073927/355533001073924. 355170561073935/355533001073932. 355170561073943/3555330010739
40. 355170561074008/355533001074005. 355170561074099/355533001074096. 355170561074115/355533001074112. 355170561074131/3555330010
74138. 355170561074198/355533001074195. 355170561074206/355533001074203. 355170561074230/355533001074237. 355170561074248/3555330
01074245. 355170561074255/355533001074252. 355170561074263/355533001074260. 355170561074370/355533001074377. 355170561074396/3555
33001074393. 355170561074412/355533001074419. 355170561074420/355533001074427. 355170561074438/355533001074435. 355170561074487/3
55533001074484. 355170561074503/355533001074500. 355170561074529/355533001074526. 355170561074537/355533001074534. 35517056107456
0/355533001074567. 355170561074578/355533001074575. 355170561074594/355533001074591. 355170561074644/355533001074641. 35517056107
4669/355533001074666. 355170561074677/355533001074674. 355170561074693/355533001074690. 355170561074727/355533001074724. 35517056
1074768/355533001074765. 355170561075088/355533001075085. 355170561075112/355533001075119. 355170561075120/355533001075127. 35517
0561075146/355533001075143.355170561075153/355533001075150. 355170561075161/355533001075168. 355170561075179/355533001075176. 355
170561075195/355533001075192. 355170561075203/355533001075200. 355170561075211/355533001075218. 355170561075245/355533001075242.
355170561075252/355533001075259. 355170561075260/355533001075267. 355170561075294/355533001075291. 355170561075344/35553300107534
032024001230399-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001230399-1 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
1. 355170561075450/355533001075457. 355170561075476/355533001075473. 355170561075559/355533001075556. 355170561075575/35553300107
5572. 355170561075583/355533001075580. 355170561075609/355533001075606.355170561075625/355533001075622. 355170561075658/355533001
075655. 355170561075682/355533001075689. 355170561075732/355533001075739. 355170561075781/355533001075788. 355170561075831/355533
001075838. 355170561075872/355533001075879. 355170561076375/355533001076372. 355170561076789/355533001076786. 355170561076805/355
533001076802. 355170561077670/355533001077677. 355170561077688/355533001077685. 355170561077712/355533001077719. 355170561077720/
355533001077727. 355170561077787/355533001077784. 355170561077878/355533001077875. 355170561077886/355533001077883. 3551705610778
94/355533001077891. 355170561077936/355533001077933. 355170561077951/355533001077958. 355170561077977/355533001077974. 3551705610
78041/355533001078048. 355170561078058/355533001078055. 355170561078124/355533001078121. 355170561078173/355533001078170. 3551705
61078199/355533001078196. 355170561078207/355533001078204. 355170561078223/355533001078220. 355170561078231/355533001078238. 3551
70561078280/355533001078287. 355170561078298/355533001078295. 355170561078306/355533001078303. 355170561078314/355533001078311. 3
55170561078348/355533001078345. 355170561078363/355533001078360. 355170561080849/355533001080846. 355170561080864/355533001080861
. 355170561081086/355533001081083. 355170561081102/355533001081109. 355170561081177/355533001081174. 355170561081185/355533001081
182. 355170561081219/355533001081216. 355170561081227/355533001081224. 355170561081243/355533001081240. 355170561081250/355533001
081257. 355170561081268/355533001081265. 355170561081284/355533001081281. 355170561081292/355533001081299. 355170561081300/355533
001081307. 355170561081334/355533001081331. 355170561081342/355533001081349. 355170561081367/355533001081364. 355170561081425/355
533001081422.355170561081441/355533001081448. 355170561081474/355533001081471. 355170561081490/355533001081497. 355170561081508/3
55533001081505. 355170561081565/355533001081562. 355170561081623/355533001081620. 355170561081656/355533001081653. 35517056108168
0/355533001081687. 355170561081730/355533001081737. 355170561081748/355533001081745. 355170561081805/355533001081802. 35517056108
2878/355533001082875. 355170561082910/355533001082917. 355170561082944/355533001082941. 355170561082951/355533001082958. 35517056
1082993/355533001082990. 355170561083009/355533001083006.355170561083017/355533001083014. 355170561083025/355533001083022. 355170
561083041/355533001083048. 355170561083066/355533001083063. 355170561083082/355533001083089. 355170561083108/355533001083105. 355
170561083579/355533001083576. 355170561083587/355533001083584. 355170561083595/355533001083592. 355170561083611/355533001083618.
355170561083637/355533001083634. 355170561083652/355533001083659. 355170561083660/355533001083667. 355170561083678/35553300108367
5. 355170561083694/355533001083691. 355170561083728/355533001083725. 355170561083736/355533001083733. 355170561083785/35553300108
3782. 355170561083876/355533001083873. 355170561083892/355533001083899. 355170561083900/355533001083907. 355170561083934/35553300
1083931. 355170561083959/355533001083956. 355170561083975/355533001083972. 355170561084056/355533001084053. 355170561084122/35553
3001084129. 355170561084148/355533001084145. 355170561084155/355533001084152. 355170561084197/355533001084194. 355170561084288/35
5533001084285. 355170561084361/355533001084368. 355170561084387/355533001084384. 355170561084403/355533001084400. 355170561084411
/355533001084418. 355170561084429/355533001084426. 355170561084460/355533001084467. 355170561084551/355533001084558. 355170561084
569/355533001084566. 355170561085152/355533001085159. 355170561085525/355533001085522. 355170561085558/355533001085555. 355170561
085616/355533001085613. 355170561085681/355533001085688. 355170561085756/355533001085753. 355170561085764/355533001085761. 355170
561098882/355533001098889. 355170561098890/355533001098897. 355170561098924/355533001098921. 355170561098932/355533001098939. 355
170561098940/355533001098947. 355170561098957/355533001098954. 355170561098965/355533001098962. 355170561098999/355533001098996.3
55170561099005/355533001099002. 355170561099047/355533001099044. 355170561099054/355533001099051. 355170561099070/355533001099077
. 355170561099708/355533001099705. 355170561099765/355533001099762. 355170561099773/355533001099770. 355170561099823/355533001099
820. 355170561099831/355533001099838. 355170561099856/355533001099853. 355170561099864/355533001099861. 355170561099872/355533001
099879. 355170561099906/355533001099903. 355170561099914/355533001099911. 355170561099922/355533001099929. 355170561099955/355533
001099952. 355170561100035/355533001100032.355170561100043/355533001100040. 355170561100100/355533001100107. 355170561100126/3555
33001100123. 355170561100159/355533001100156. 355170561100175/355533001100172. 355170561100209/355533001100206. 355170561100217/3
55533001100214. 355170561100225/355533001100222. 355170561100241/355533001100248. 355170561100274/355533001100271. 35517056110028
2/355533001100289. 355170561100290/355533001100297. 355170561100316/355533001100313. 355170561100332/355533001100339. 35517056110
0340/355533001100347. 355170561100357/355533001100354. 355170561100373/355533001100370. 355170561100399/355533001100396. 35517056
1100415/355533001100412. 355170561103211/355533001103218. 355170561103245/355533001103242. 355170561103344/355533001103341. 35517
0561103427/355533001103424. 355170561103468/355533001103465. 355170561103500/355533001103507. 355170561103526/355533001103523. 35
5170561103542/355533001103549. 355170561103559/355533001103556. 355170561103567/355533001103564. 355170561103591/355533001103598.
355170561103609/355533001103606. 355170561103641/355533001103648. 355170561103658/355533001103655. 355170561103666/3555330011036
63. 355170561103674/355533001103671. 355170561103716/355533001103713. 355170561103807/355533001103804. 355170561103831/3555330011
03838. 355170561103849/355533001103846. 355170561103856/355533001103853. 355170561103864/355533001103861. 355170561103880/3555330
01103887. 355170561103898/355533001103895. 355170561103906/355533001103903. 355170561103948/355533001103945. 355170561103955/3555
33001103952. 355170561103963/355533001103960. 355170561103989/355533001103986. 355170561104003/355533001104000. 355170561104011/3
55533001104018. 355170561104045/355533001104042. 355170561104052/355533001104059. 355170561104060/355533001104067.355170561104078
/355533001104075. 355170561104086/355533001104083. 355170561104102/355533001104109. 355170561104110/355533001104117. 355170561104
136/355533001104133. 355170561104144/355533001104141. 355170561104151/355533001104158. 355170561104177/355533001104174. 355170561
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032024001230399-1
Espacio para uso exclusivo de la Entidad Recaudadora
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