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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
032024001356006-4
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 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. 116575014825732 2024 – 09 – 28 No. HKG0364812 2024 – 09 – 23
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 6900302691 2024 – 09 – 20 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
4.188.11
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
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 79.75 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
99.00
290.00
78 .Valor FOB 79 . Valor fletes USD USD
14.850.82
719.73
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
0.75
0
Arancel
0
0
0.00
92 93 94 0.00 65.214.317
95
96
I.V.A.
9798 99 100 101
0.00 65.214.317 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
720.48
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
15.571.30
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: 532623-DECL: 1843761-DO: 893122871241- 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. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOMOL
OGACIÓN)// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA
S.A. OEA COD. OE0001. . PEDIDOS: 3073758291. ID CONTENEDOR: 6078197477. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A065MLGGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A06 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE CLA(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 032024001356006
133. Feha: 202409 30
134 . Levante No. 032024001273467 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 30
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 92032407264409
Fecha presentación 2024-09-30 12:48:21 Valor pagado $0.00
Fecha de Impresión: 2024-09-30 12:48:28
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001356006-4 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
RO, MODELO: SM-A065M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A065M/DS,LIGHT GREEN,LTC( QTY. 290,00 u )(2
90,00 PCE); IMEIS: 354106703673746/357809263673744. 354106703673761/357809263673769. 354106703673977/357809263673975. 35410670367
4033/357809263674031. 354106703674074/357809263674072. 354106703674215/357809263674213. 354106703674231/357809263674239. 35410670
3674389/357809263674387. 354106703674397/357809263674395. 354106703674405/357809263674403. 354106703674413/357809263674411. 35410
6703674421/357809263674429. 354106703674454/357809263674452.354106703674504/357809263674502. 354106703674512/357809263674510. 354
106703674587/357809263674585. 354106703674595/357809263674593. 354106703674629/357809263674627. 354106703674835/357809263674833.
354106703674850/357809263674858. 354106703674868/357809263674866. 354106703675246/357809263675244. 354106703675386/35780926367538
4. 354106703675626/357809263675624. 354106703675667/357809263675665. 354106703675683/3578092 63675681. 354106703675725/3578092636
75723. 354106703675782/357809263675780. 354106703675857/357809263675855. 354106703675915/357809263675913. 354106703675923/3578092
63675921. 354106703676020/357809263676028. 354106703676038/357809263676036. 354106703676111/357809263676119. 354106703676129/3578
09263676127. 354106703676145/357809263676143. 354106703676160/357809263676168. 354106703676178/357809263676176. 354106703676202/3
57809263676200. 354106703676210/357809263676218. 354106703676244/357809263676242. 354106703676251/357809263676259. 35410670367630
1/357809263676309. 354106703676376/357809263676374. 354106703676400/357809263676408. 354106703676459/357809263676457. 35410670367
6467/357809263676465. 354106703676483/357809263676481. 354106703676509/357809263676507. 354106703676517/357809263676515. 35410670
3676525/357809263676523. 354106703676533/357809263676531. 354106703676558/357809263676556. 354106703676566/357809263676564. 35410
6703676574/357809263676572. 354106703676582/357809263676580. 354106703676590/357809263676598. 354106703676616/357809263676614. 35
4106703676640/357809263676648. 354106703676657/357809263676655. 354106703676665/357809263676663. 354106703676673/357809263676671.
354106703676715/357809263676713. 354106703676723/357809263676721. 354106703676731/357809263676739. 354106703676749/3578092636767
47.354106703676764/357809263676762. 354106703676772/357809263676770. 354106703676780/357809263676788. 354106703676806/35780926367
6804. 354106703676814/357809263676812. 354106703676822/357809263676820. 354106703676830/357809263676838. 354106703676855/35780926
3676853. 354106703676863/357809263676861. 354106703676871/357809263676879. 354106703676889/357809263676887. 354106703676897/35780
9263676895. 354106703676905/357809263676903. 354106703676913/357809263676911. 354106703676947/357809263676945. 354106703676954/35
7809263676952. 354106703676970/357809263676978.354106703677168/357809263677166. 354106703677218/357809263677216. 354106703677259/
357809263677257. 354106703677275/357809263677273. 354106703677283/357809263677281. 354106703677291/357809263677299. 3541067036773
09/357809263677307. 354106703677341/357809263677349. 354106703677358/357809263677356. 354106703677374/357809263677372. 3541067036
77382/357809263677380. 354106703677408/357809263677406. 354106703677424/357809263677422. 354106703677440/357809263677448. 3541067
03677457/357809263677455. 354106703677473/357809263677471. 354106703677481/357809263677489. 354106703677507/357809263677505. 3541
06703677531/357809263677539. 354106703677564/357809263677562. 354106703677572/357809263677570. 354106703677580/357809263677588. 3
54106703677606/357809263677604. 354106703677630/357809263677638. 354106703677689/357809263677687. 354106703677697/357809263677695
. 354106703677713/357809263677711. 354106703677747/357809263677745. 354106703677754/357809263677752. 354106703677762/357809263677
760. 354106703677770/357809263677778. 354106703677788/357809263677786. 354106703677796/357809263677794. 354106703677804/357809263
677802. 354106703677820/357809263677828. 354106703677853/357809263677851. 354106703677861/357809263677869. 354106703677887/357809
263677885. 354106703677895/357809263677893. 354106703677911/357809263677919. 354106703677937/357809263677935. 354106703677945/357
809263677943. 354106703677952/357809263677950. 354106703677986/357809263677984. 354106703678018/357809263678016. 354106703678042/
357809263678040. 354106703678125/357809263678123. 354106703678133/357809263678131. 354106703678158/357809263678156. 3541067036782
24/357809263678222. 354106703678505/357809263678503. 354106703678810/357809263678818. 354106703678869/357809263678867.35410670367
9073/357809263679071. 354106703679164/357809263679162. 354106703679214/357809263679212. 354106703679537/357809263679535. 35410670
3679693/357809263679691. 354106703679743/357809263679741. 354106703679826/357809263679824. 354106703679909/357809263679907. 35410
6703679974/357809263679972. 354106703680154/357809263680152. 354106703680386/357809263680384. 354106703680717/357809263680715. 35
4106703680733/357809263680731. 354106703681152/357809263681150. 354106703681368/357809263681366. 354106703681509/357809263681507.
354106703682473/357809263682471.354106703682838/357809263682836. 354106703683141/357809263683149. 354106703683307/35780926368330
5. 354106703683489/357809263683487. 354106703683547/357809263683545. 354106703683554/357809263683552. 354106703684065/35780926368
4063. 354106703684214/357809263684212. 354106703684404/357809263684402. 354106703684412/357809263684410. 354106703684495/35780926
3684493. 354106703684511/357809263684519. 354106703684594/357809263684592. 354106703684636/357809263684634. 354106703684651/35780
9263684659. 354106703684990/357809263684998. 354106703685245/357809263685243. 354106703685328/357809263685326. 354106703685617/35
7809263685615. 354106703686094/357809263686092. 354106703686177/357809263686175. 354106703686219/357809263686217. 354106703686334
/357809263686332. 354106703686649/357809263686647. 354106703686755/357809263686753. 354106703686821/357809263686829. 354106703686
912/357809263686910. 354106703686953/357809263686951. 354106703687217/357809263687215. 354106703687324/357809263687322. 354106703
687332/357809263687330. 354106703687340/357809263687348. 354106703687365/357809263687363. 354106703687381/357809263687389. 354106
703687415/357809263687413. 354106703687522/357809263687520. 354106703687548/357809263687546. 354106703687555/357809263687553. 354
106703687597/357809263687595. 354106703687613/357809263687611. 354106703687621/357809263687629. 354106703687654/357809263687652.
354106703687670/357809263687678. 354106703687704/357809263687702. 354106703687720/357809263687728. 354106703687746/35780926368774
4. 354106703687753/357809263687751. 354106703687779/357809263687777. 354106703687787/357809263687785. 354106703687795/35780926368
7793. 354106703687829/357809263687827. 354106703687837/357809263687835. 354106703687845/357809263687843.354106703687852/357809263
687850. 354106703687878/357809263687876. 354106703687886/357809263687884. 354106703687894/357809263687892. 354106703687902/357809
263687900. 354106703688538/357809263688536. 354106703688579/357809263688577. 354106703689452/357809263689450. 354106703689999/357
809263689997. 354106703690088/357809263690086. 354106703690773/357809263690771. 354106703692738/357809263692736. 354106703693215/
357809263693213. 354106703693231/357809263693239. 354106703693264/357809263693262. 354106703693280/357809263693288. 3541067036933
06/357809263693304.354106703693322/357809263693320. 354106703693348/357809263693346. 354106703693355/357809263693353. 35410670369
3363/357809263693361. 354106703693371/357809263693379. 354106703693389/357809263693387. 354106703693397/357809263693395. 35410670
3693447/357809263693445. 354106703693462/357809263693460. 354106703693488/357809263693486. 354106703694007/357809263694005. 35410
6703694304/357809263694302. 354106703694346/357809263694344. 354106703694403/357809263694401. 354106703694429/357809263694427. 35
4106703694445/357809263694443. 354106703694478/357809263694476. 354106703694528/357809263694526. 354106703694577/357809263694575.
354106703694593/357809263694591. 354106703694866/357809263694864. 354106703694874/357809263694872. 354106703694965/3578092636949
63. 354106703694973/357809263694971. 354106703695004/357809263695002. 354106703695012/357809263695010. 354106703695020/3578092636
95028. 354106703695038/357809263695036. 354106703695053/357809263695051. 354106703695061/357809263695069. 354106703695079/3578092
63695077. 354106703695103/357809263695101. 354106703695194/357809263695192. 354106703695301/357809263695309. 354106703695327/3578
09263695325. 354106703695400/357809263695408. 354106703695426/357809263695424. 354106703695467/357809263695465. 354106703695483/3
57809263695481. 354106703695533/357809263695531. 354106703695541/357809263695549. 354106703695590/357809263695598. 35410670369563
2/357809263695630. 354106703695707/357809263695705. 354106703695822/357809263695820. 354106703695889/357809263695887. 35410670369
5913/357809263695911. 354106703695921/357809263695929. 354106703695954/357809263695952. 354106703696028/357809263696026. 35410670
3696036/357809263696034. 354106703696044/357809263696042. 354106703696051/357809263696059.354106703696093/357809263696091. 354106
703696168/357809263696166. 354106703696184/357809263696182. 354106703696192/357809263696190. 354106703696861/357809263696869. 354
106703696937/357809263696935. 354106703696952/357809263696950. 354106703696986/357809263696984. 354106703697026/357809263697024.
354106703697117/357809263697115. 354106703697166/357809263697164. 354106703697208/357809263697206. 354106703697232/35780926369723
032024001356006-4
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001356006-4 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
0. 354106703697281/357809263697289XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001356006-4
Espacio para uso exclusivo de la Entidad Recaudadora
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