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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
032024001319034-3
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. 116575014802137 2024 – 09 – 21 No. HKG0380721 2024 – 09 – 17
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 6900300281 2024 – 09 – 11 procedencia 351
54 . Cod. Modo Transporte
4
55 . Código de Bandera
244
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. EMIRATES SUCURSAL COLOMBIA
4.175.10
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 81.30 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
112.00
300.00
78 .Valor FOB 79 . Valor fletes USD USD
13.371.57
744.80
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
0.68
0
Arancel
0
0
0.00
92 93 94 0.00 58.940.095
95
96
I.V.A.
9798 99 100 101
0.00 58.940.095 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
745.48
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
14.117.05
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: 531646-DECL: 1841277-DO: 893122260241- 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: 3073746164. ID CONTENEDOR: 6078042824. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A055MZKDLTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, M(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 032024001319034
133. Feha: 202409 23
134 . Levante No. 032024001239596 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 23
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 92032407073796
Fecha presentación 2024-09-23 13:23:11 Valor pagado $0.00
Fecha de Impresión: 2024-09-23 13:23:22
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001319034-3 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,BLACK,LTC( QTY. 300,00 u )(300,00 PCE);
IMEIS: 351864757058031/354706947058032. 351864757058049/354706947058040. 351864757058114/354706947058115. 351864757058122/354706
947058123. 351864757058130/354706947058131. 351864757058155/354706947058156. 351864757058163/354706947058164. 351864757058171/354
706947058172. 351864757058197/354706947058198. 351864757058213/354706947058214. 351864757058247/354706947058248. 351864757058254/
354706947058255. 351864757058361/354706947058362. 351864757058395/354706947058396. 351864757058437/354706947058438. 3518647570585
02/354706947058503. 351864757058510/354706947058511. 351864757058536/354706947058537. 351864757058544/354706947058545. 3518647570
58551/354706947058552. 351864757058593/354706947058594. 351864757058601/354706947058602. 351864757058627/354706947058628. 3518647
57058635/354706947058636. 351864757058650/354706947058651. 351864757058668/354706947058669. 351864757058684/354706947058685. 3518
64757058700/354706947058701. 351864757058718/354706947058719. 351864757058742/354706947058743. 351864757058759/354706947058750. 3
51864757058767/354706947058768. 351864757058775/354706947058776. 351864757058783/354706947058784. 351864757058791/354706947058792
. 351864757058809/354706947058800. 351864757058866/354706947058867. 351864757058874/354706947058875. 351864757058890/354706947058
891. 351864757058908/354706947058909. 351864757058916/354706947058917. 351864757058932/354706947058933. 351864757058940/354706947
058941.351864757058957/354706947058958. 351864757058965/354706947058966. 351864757058973/354706947058974. 351864757058981/3547069
47058982. 351864757058999/354706947058990. 351864757059005/354706947059006. 351864757059013/354706947059014. 351864757059021/3547
06947059022. 351864757059039/354706947059030. 351864757059047/354706947059048. 351864757059062/354706947059063. 351864757059070/3
54706947059071. 351864757059104/354706947059105. 351864757059112/354706947059113. 351864757059120/354706947059121. 35186475705913
8/354706947059139. 351864757059146/354706947059147. 351864757059153/354706947059154. 351864757059161/354706947059162. 35186475705
9179/354706947059170. 351864757059203/354706947059204. 351864757059302/354706947059303. 351864757059336/354706947059337. 35186475
7059393/354706947059394. 351864757059575/354706947059576. 351864757059773/354706947059774. 351864757060029/354706947060020. 35186
4757060060/354706947060061. 351864757060078/354706947060079. 351864757060094/354706947060095. 351864757060102/354706947060103. 35
1864757060110/354706947060111. 351864757060128/354706947060129. 351864757060136/354706947060137. 351864757060144/354706947060145.
351864757060151/354706947060152. 351864757060169/354706947060160. 351864757060185/354706947060186. 351864757060201/3547069470602
02. 351864757060219/354706947060210. 351864757060227/354706947060228. 351864757060235/354706947060236. 351864757060243/3547069470
60244. 351864757060250/354706947060251. 351864757060284/354706947060285. 351864757060318/354706947060319. 351864757060342/3547069
47060343. 351864757060391/354706947060392. 351864757060417/354706947060418. 351864757060490/354706947060491. 351864757060524/3547
06947060525. 351864757060532/354706947060533. 351864757060565/354706947060566.351864757060573/354706947060574. 351864757060581/35
4706947060582. 351864757060607/354706947060608. 351864757060615/354706947060616. 351864757060649/354706947060640. 351864757060656
/354706947060657. 351864757060706/354706947060707. 351864757060714/354706947060715. 351864757060722/354706947060723. 351864757060
730/354706947060731. 351864757060748/354706947060749. 351864757060755/354706947060756. 351864757060771/354706947060772. 351864757
060789/354706947060780. 351864757060797/354706947060798. 351864757060805/354706947060806. 351864757060813/354706947060814.3518647
57060847/354706947060848. 351864757060888/354706947060889. 351864757061019/354706947061010. 351864757061035/354706947061036. 3518
64757061050/354706947061051. 351864757061076/354706947061077. 351864757061233/354706947061234. 351864757051044/354706947051045. 3
51864757051051/354706947051052. 351864757051069/354706947051060. 351864757051085/354706947051086. 351864757051093/354706947051094
. 351864757051101/354706947051102. 351864757051119/354706947051110. 351864757052240/354706947052241. 351864757052257/354706947052
258. 351864757052265/354706947052266. 351864757052273/354706947052274. 351864757052281/354706947052282. 351864757052299/354706947
052290. 351864757052307/354706947052308. 351864757052315/354706947052316. 351864757052323/354706947052324. 351864757052331/354706
947052332. 351864757052349/354706947052340. 351864757052364/354706947052365. 351864757052901/354706947052902. 351864757052919/354
706947052910. 351864757052927/354706947052928. 351864757052935/354706947052936. 351864757052943/354706947052944. 351864757052950/
354706947052951. 351864757052968/354706947052969. 351864757052976/354706947052977. 351864757053297/354706947053298. 3518647570533
13/354706947053314. 351864757053321/354706947053322. 351864757053339/354706947053330. 351864757053347/354706947053348. 3518647570
53354/354706947053355. 351864757053362/354706947053363. 351864757053370/354706947053371. 351864757053388/354706947053389. 3518647
57053396/354706947053397. 351864757053420/354706947053421. 351864757053438/354706947053439. 351864757053446/354706947053447. 3518
64757053453/354706947053454. 351864757053479/354706947053470. 351864757053511/354706947053512. 351864757053529/354706947053520. 3
51864757053537/354706947053538. 351864757053545/354706947053546.351864757053560/354706947053561. 351864757053586/354706947053587.
351864757053594/354706947053595. 351864757053602/354706947053603. 351864757053610/354706947053611. 351864757053651/3547069470536
52. 351864757053719/354706947053710. 351864757053727/354706947053728. 351864757053735/354706947053736. 351864757053750/3547069470
53751. 351864757053768/354706947053769. 351864757053776/354706947053777. 351864757053784/354706947053785. 351864757053792/3547069
47053793. 351864757053800/354706947053801. 351864757053974/354706947053975. 351864757054022/354706947054023.351864757054030/35470
6947054031. 351864757054048/354706947054049. 351864757054188/354706947054189. 351864757054238/354706947054239. 351864757054246/35
4706947054247. 351864757054253/354706947054254. 351864757054279/354706947054270. 351864757054303/354706947054304. 351864757054329
/354706947054320. 351864757054410/354706947054411. 351864757054444/354706947054445. 351864757054451/354706947054452. 351864757054
469/354706947054460. 351864757054477/354706947054478. 351864757054543/354706947054544. 351864757054576/354706947054577. 351864757
054584/354706947054585. 351864757054592/354706947054593. 351864757054618/354706947054619. 351864757054626/354706947054627. 351864
757054634/354706947054635. 351864757054642/354706947054643. 351864757054667/354706947054668. 351864757054675/354706947054676. 351
864757054683/354706947054684. 351864757054691/354706947054692. 351864757054709/354706947054700. 351864757054717/354706947054718.
351864757054725/354706947054726. 351864757054733/354706947054734. 351864757054741/354706947054742. 351864757054766/35470694705476
7. 351864757054774/354706947054775. 351864757054782/354706947054783. 351864757054808/354706947054809. 351864757054816/35470694705
4817. 351864757054824/354706947054825. 351864757054832/354706947054833. 351864757054840/354706947054841. 351864757054857/35470694
7054858. 351864757054907/354706947054908. 351864757054915/354706947054916. 351864757054923/354706947054924. 351864757054931/35470
6947054932. 351864757054998/354706947054999. 351864757055151/354706947055152. 351864757055169/354706947055160. 351864757055177/35
4706947055178. 351864757055201/354706947055202. 351864757055227/354706947055228. 351864757055235/354706947055236. 351864757055243
/354706947055244. 351864757055250/354706947055251.351864757055631/354706947055632. 351864757055664/354706947055665. 3518647570556
72/354706947055673. 351864757055680/354706947055681. 351864757055706/354706947055707. 351864757055722/354706947055723. 3518647570
55839/354706947055830. 351864757055847/354706947055848. 351864757055854/354706947055855. 351864757055888/354706947055889. 3518647
57055920/354706947055921. 351864757055946/354706947055947. 351864757055961/354706947055962. 351864757055979/354706947055970. 3518
64757055995/354706947055996. 351864757056001/354706947056002. 351864757056019/354706947056010.351864757056027/354706947056028. 35
1864757056035/354706947056036. 351864757056043/354706947056044. 351864757056068/354706947056069. 351864757056076/354706947056077.
351864757056084/354706947056085. 351864757056092/354706947056093. 351864757056423/354706947056424. 351864757056753/3547069470567
54. 351864757056779/354706947056770. 351864757056829/354706947056820. 351864757056845/354706947056846. 351864757057116/3547069470
57117. 351864757057306/354706947057307. 351864757057355/354706947057356. 351864757057389/354706947057380. 351864757057413/3547069
47057414. 351864757057512/354706947057513. 351864757057538/354706947057539. 351864757057553/354706947057554. 351864757057561/3547
06947057562. 351864757057587/354706947057588. 351864757057595/354706947057596. 351864757057603/354706947057604. 351864757057611/3
54706947057612. 351864757057629/354706947057620. 351864757057637/354706947057638. 351864757057645/354706947057646. 35186475705765
2/354706947057653. 351864757057660/354706947057661. 351864757057678/354706947057679. 351864757057686/354706947057687. 35186475705
7710/354706947057711. 351864757057728/354706947057729. 351864757057736/354706947057737. 351864757057744/354706947057745. 35186475
032024001319034-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001319034-3 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
7057751/354706947057752. 351864757057769/354706947057760. 351864757057785/354706947057786. 351864757057793/354706947057794. 35186
4757057819/354706947057810. 351864757057835/354706947057836. 351864757057876/354706947057877. 351864757057884/354706947057885. 35
1864757057892/354706947057893. 351864757057900/354706947057901. 351864757058015/354706947058016XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001319034-3
Espacio para uso exclusivo de la Entidad Recaudadora
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