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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
032024001381388-8
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. 116575014856759 2024 – 10 – 08 No. HKG0380768 2024 – 10 – 02
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 6900305610 2024 – 09 – 25 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 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
13.327.72
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 58.940.110
95
96
I.V.A.
9798 99 100 101
0.00 58.940.110 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
14.073.20
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: 533147-DECL: 1845155-DO: 893123462241- 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: 3074298852. ID CONTENEDOR: 6078309132. 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 032024001381388
133. Feha: 202410 03
134 . Levante No. 032024001322762 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 10 – 09
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 92032407396331
Fecha presentación 2024-10-03 19:13:51 Valor pagado $0.00
Fecha de Impresión: 2024-10-09 12:55:30
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001381388-8 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: 351864758383065/354706948383066. 351864758383099/354706948383090. 351864758383123/354706948383124. 351864758383149/354706
948383140. 351864758383230/354706948383231. 351864758383255/354706948383256. 351864758383271/354706948383272. 351864758383297/354
706948383298. 351864758383347/354706948383348. 351864758383362/354706948383363. 351864758383420/354706948383421. 351864758383586/
354706948383587. 351864758383719/354706948383710. 351864758383784/354706948383785. 351864758383875/354706948383876. 3518647583838
91/354706948383892. 351864758383917/354706948383918. 351864758383925/354706948383926. 351864758383982/354706948383983. 3518647583
84022/354706948384023. 351864758384030/354706948384031. 351864758384055/354706948384056. 351864758384071/354706948384072. 3518647
58384097/354706948384098. 351864758384196/354706948384197. 351864758384204/354706948384205. 351864758384212/354706948384213. 3518
64758384253/354706948384254. 351864758384279/354706948384270. 351864758384287/354706948384288. 351864758384360/354706948384361. 3
51864758384436/354706948384437. 351864758384451/354706948384452. 351864758384477/354706948384478. 351864758384550/354706948384551
. 351864758384600/354706948384601. 351864758384675/354706948384676. 351864758384758/354706948384759. 351864758384816/354706948384
817. 351864758384865/354706948384866. 351864758384956/354706948384957. 351864758385011/354706948385012. 351864758385391/354706948
385392.351864758385573/354706948385574. 351864758385680/354706948385681. 351864758385698/354706948385699. 351864758385714/3547069
48385715. 351864758385847/354706948385848. 351864758385862/354706948385863. 351864758385870/354706948385871. 351864758385896/3547
06948385897. 351864758385961/354706948385962. 351864758386001/354706948386002. 351864758386068/354706948386069. 351864758386258/3
54706948386259. 351864758386266/354706948386267. 351864758386290/354706948386291. 351864758386357/354706948386358. 35186475838636
5/354706948386366. 351864758386555/354706948386556. 351864758386589/354706948386580. 351864758386605/354706948386606. 35186475838
6654/354706948386655. 351864758386688/354706948386689. 351864758386712/354706948386713. 351864758386720/354706948386721. 35186475
8386779/354706948386770. 351864758386787/354706948386788. 351864758387082/354706948387083. 351864758389344/354706948389345. 35186
4758390797/354706948390798. 351864758392140/354706948392141. 351864758393940/354706948393941. 351864758395093/354706948395094. 35
1864758395341/354706948395342. 351864758395358/354706948395359. 351864758395374/354706948395375. 351864758395390/354706948395391.
351864758395556/354706948395557. 351864758395564/354706948395565. 351864758395655/354706948395656. 351864758396216/3547069483962
17. 351864758396380/354706948396381. 351864758396448/354706948396449. 351864758396547/354706948396548. 351864758396679/3547069483
96670. 351864758396703/354706948396704. 351864758396711/354706948396712. 351864758396810/354706948396811. 351864758397289/3547069
48397280. 351864758397479/354706948397470. 351864758397669/354706948397660. 351864758397719/354706948397710. 351864758397792/3547
06948397793. 351864758397826/354706948397827. 351864758397933/354706948397934.351864758397974/354706948397975. 351864758397990/35
4706948397991. 351864758398014/354706948398015. 351864758398089/354706948398080. 351864758398097/354706948398098. 351864758398147
/354706948398148. 351864758398303/354706948398304. 351864758398345/354706948398346. 351864758398360/354706948398361. 351864758398
402/354706948398403. 351864758398428/354706948398429. 351864758398444/354706948398445. 351864758398535/354706948398536. 351864758
398584/354706948398585. 351864758398634/354706948398635. 351864758398659/354706948398650. 351864758398675/354706948398676.3518647
58398709/354706948398700. 351864758398741/354706948398742. 351864758398857/354706948398858. 351864758398931/354706948398932. 3518
64758398998/354706948398999. 351864758399145/354706948399146. 351864758399194/354706948399195. 351864758399228/354706948399229. 3
51864758399236/354706948399237. 351864758399244/354706948399245. 351864758399293/354706948399294. 351864758399335/354706948399336
. 351864758399350/354706948399351. 351864758399368/354706948399369. 351864758399384/354706948399385. 351864758399400/354706948399
401. 351864758399434/354706948399435. 351864758399442/354706948399443. 351864758399467/354706948399468. 351864758399475/354706948
399476. 351864758399483/354706948399484. 351864758399509/354706948399500. 351864758399533/354706948399534. 351864758399566/354706
948399567. 351864758399582/354706948399583. 351864758399590/354706948399591. 351864758399616/354706948399617. 351864758399681/354
706948399682. 351864758399699/354706948399690. 351864758399707/354706948399708. 351864758399749/354706948399740. 351864758399863/
354706948399864. 351864758399889/354706948399880. 351864758399897/354706948399898. 351864758399954/354706948399955. 3518647584003
07/354706948400308. 351864758400372/354706948400373. 351864758400604/354706948400605. 351864758400695/354706948400696. 3518647584
00810/354706948400811. 351864758400950/354706948400951. 351864758400968/354706948400969. 351864758401081/354706948401082. 3518647
58401123/354706948401124. 351864758401131/354706948401132. 351864758401156/354706948401157. 351864758401206/354706948401207. 3518
64758401214/354706948401215. 351864758401230/354706948401231. 351864758401248/354706948401249. 351864758401255/354706948401256. 3
51864758401271/354706948401272. 351864758401289/354706948401280.351864758401313/354706948401314. 351864758401321/354706948401322.
351864758401370/354706948401371. 351864758401404/354706948401405. 351864758401446/354706948401447. 351864758401453/3547069484014
54. 351864758401487/354706948401488. 351864758401495/354706948401496. 351864758401552/354706948401553. 351864758401602/3547069484
01603. 351864758401636/354706948401637. 351864758401693/354706948401694. 351864758401701/354706948401702. 351864758401719/3547069
48401710. 351864758401750/354706948401751. 351864758401883/354706948401884. 351864758401933/354706948401934.351864758401941/35470
6948401942. 351864758401990/354706948401991. 351864758402055/354706948402056. 351864758402063/354706948402064. 351864758402097/35
4706948402098. 351864758402238/354706948402239. 351864758402287/354706948402288. 351864758402345/354706948402346. 351864758402444
/354706948402445. 351864758402527/354706948402528. 351864758402535/354706948402536. 351864758402659/354706948402650. 351864758402
816/354706948402817. 351864758402824/354706948402825. 351864758402840/354706948402841. 351864758403053/354706948403054. 351864758
403129/354706948403120. 351864758403160/354706948403161. 351864758403194/354706948403195. 351864758403210/354706948403211. 351864
758403236/354706948403237. 351864758403269/354706948403260. 351864758403335/354706948403336. 351864758403392/354706948403393. 351
864758403426/354706948403427. 351864758403491/354706948403492. 351864758403525/354706948403526. 351864758403558/354706948403559.
351864758403582/354706948403583. 351864758403590/354706948403591. 351864758403608/354706948403609. 351864758403624/35470694840362
5. 351864758403640/354706948403641. 351864758403681/354706948403682. 351864758403699/354706948403690. 351864758403731/35470694840
3732. 351864758403756/354706948403757. 351864758403848/354706948403849. 351864758404184/354706948404185. 351864758404614/35470694
8404615. 351864758404622/354706948404623. 351864758404648/354706948404649. 351864758404671/354706948404672. 351864758404697/35470
6948404698. 351864758404838/354706948404839. 351864758404895/354706948404896. 351864758405488/354706948405489. 351864758405579/35
4706948405570. 351864758406379/354706948406370. 351864758407021/354706948407022. 351864758407104/354706948407105. 351864758407138
/354706948407139. 351864758407278/354706948407279.351864758408565/354706948408566. 351864758408961/354706948408962. 3518647584096
21/354706948409622. 351864758409647/354706948409648. 351864758410355/354706948410356. 351864758410389/354706948410380. 3518647584
10934/354706948410935. 351864758410967/354706948410968. 351864758411031/354706948411032. 351864758411171/354706948411172. 3518647
58411387/354706948411388. 351864758411395/354706948411396. 351864758411429/354706948411420. 351864758411478/354706948411479. 3518
64758411577/354706948411578. 351864758411692/354706948411693. 351864758411700/354706948411701.351864758411742/354706948411743. 35
1864758411973/354706948411974. 351864758381515/354706948381516. 351864758381549/354706948381540. 351864758381556/354706948381557.
351864758381622/354706948381623. 351864758381713/354706948381714. 351864758381721/354706948381722. 351864758381788/3547069483817
89. 351864758381804/354706948381805. 351864758381812/354706948381813. 351864758381820/354706948381821. 351864758381846/3547069483
81847. 351864758381853/354706948381854. 351864758381879/354706948381870. 351864758381911/354706948381912. 351864758381937/3547069
48381938. 351864758381945/354706948381946. 351864758381952/354706948381953. 351864758381960/354706948381961. 351864758381978/3547
06948381979. 351864758381994/354706948381995. 351864758382000/354706948382001. 351864758382018/354706948382019. 351864758382026/3
54706948382027. 351864758382034/354706948382035. 351864758382059/354706948382050. 351864758382067/354706948382068. 35186475838209
1/354706948382092. 351864758382109/354706948382100. 351864758382117/354706948382118. 351864758382125/354706948382126. 35186475838
2133/354706948382134. 351864758382141/354706948382142. 351864758382190/354706948382191. 351864758382356/354706948382357. 35186475
032024001381388-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001381388-8 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
8382398/354706948382399. 351864758382406/354706948382407. 351864758382513/354706948382514. 351864758382521/354706948382522. 35186
4758382539/354706948382530. 351864758382562/354706948382563. 351864758382570/354706948382571. 351864758382588/354706948382589. 35
1864758382596/354706948382597. 351864758382612/354706948382613. 351864758382919/354706948382910XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001381388-8
Espacio para uso exclusivo de la Entidad Recaudadora
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