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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
032024001246634-8
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 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. 116575014747362 2024 – 09 – 07 No. 734893023800 2024 – 09 – 05
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 9102857956 2024 – 09 – 05 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
249
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. FEDERAL EXPRESS CORPORATION
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
154.50
500.00
78 .Valor FOB 79 . Valor fletes USD USD
49.601.53
939.70
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
942.15
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: 529987-DECL: 1837213-DO: 893120980241- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN) // NOSACOGEMOS: AL DECRETO 0925 DE 2013, MERC
ANCIA QUE NO REQUIERE REGISTRODE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3072686142. ID CONTEN
EDOR: 6077853514. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A155MZKILTC, PRODUCTO: TELEFONO CELULAR GALAXY A15 5GDUOS, (CON ACCESOR
IOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, MODELO: SM-A155M/DSN, USO O DESTINO: PARA LA VENTA AL (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 032024001246634
133. Feha: 202409 09
134 . Levante No. 032024001171607 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 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 92032406696916
Fecha presentación 2024-09-09 16:21:22 Valor pagado $0.00
Fecha de Impresión: 2024-09-09 16:21:30
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001246634-8 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MAYOR Y AL DETAL/ /MOBILE,SM-A155M/DSN,BLACK,LTC( QTY. 500,00 u )(500,00 PCE); IMEIS: 355170561137417/355533001137414. 3551705611
37441/355533001137448. 355170561137516/355533001137513. 355170561137524/355533001137521. 355170561137540/355533001137547. 3551705
61137557/355533001137554. 355170561137565/355533001137562. 355170561137573/355533001137570. 355170561137581/355533001137588. 3551
70561137607/355533001137604. 355170561137615/355533001137612. 355170561137623/355533001137620. 355170561137722/355533001137729. 3
55170561137730/355533001137737. 355170561137748/355533001137745. 355170561137755/355533001137752. 355170561137763/355533001137760
. 355170561137805/355533001137802. 355170561137821/355533001137828. 355170561137839/355533001137836. 355170561137847/355533001137
844. 355170561137854/355533001137851. 355170561137862/355533001137869. 355170561137888/355533001137885. 355170561137912/355533001
137919. 355170561137946/355533001137943. 355170561138001/355533001138008. 355170561138019/3 55533001138016. 355170561138027/35553
3001138024. 355170561138035/355533001138032. 355170561138043/355533001138040. 355170561138050/355533001138057. 355170561138084/35
5533001138081. 355170561138092/355533001138099. 355170561138100/355533001138107. 355170561138118/355533001138115.355170561138126/
355533001138123. 355170561138134/355533001138131. 355170561138142/355533001138149. 355170561138167/355533001138164. 3551705611381
83/355533001138180. 355170561138191/355533001138198. 355170561138217/355533001138214. 355170561138225/355533001138222. 3551705611
38233/355533001138230. 355170561138258/355533001138255. 355170561138316/355533001138313. 355170561138340/355533001138347. 3551705
61138373/355533001138370. 355170561138407/355533001138404. 355170561138423/355533001138420. 355170561172380/355533001172387. 3551
70561172422/355533001172429.355170561172455/355533001172452. 355170561172570/355533001172577. 355170561173081/355533001173088. 35
5170561173115/355533001173112. 355170561173123/355533001173120. 355170561173131/355533001173138. 355170561175516/355533001175513.
355170561109648/355533001109645. 355170561109671/355533001109678. 355170561110000/355533001110007. 355170561113103/3555330011131
00. 355170561113111/355533001113118. 355170561113129/355533001113126. 355170561113160/355533001113167. 355170561116429/3555330011
16426. 355170561116445/355533001116442. 355170561116452/355533001116459. 355170561116478/355533001116475. 355170561119555/3555330
01119552. 355170561121908/355533001121905. 355170561122435/355533001122432. 355170561122450/355533001122457. 355170561122500/3555
33001122507. 355170561122567/355533001122564. 355170561122591/355533001122598. 355170561122617/355533001122614. 355170561122633/3
55533001122630. 355170561122682/355533001122689. 355170561122757/355533001122754. 355170561122930/355533001122937. 35517056112303
7/355533001123034. 355170561123052/355533001123059. 355170561123128/355533001123125. 355170561123144/355533001123141. 35517056112
3151/355533001123158. 355170561123169/355533001123166. 355170561123177/355533001123174. 355170561123193/355533001123190. 35517056
1123201/355533001123208. 355170561123219/355533001123216. 355170561123227/355533001123224. 355170561123243/355533001123240. 35517
0561123318/355533001123315. 355170561123367/355533001123364. 355170561123391/355533001123398. 355170561123417/355533001123414. 35
5170561123474/355533001123471. 355170561123490/355533001123497. 355170561123581/355533001123588. 355170561123714/355533001123711.
355170561123755/355533001123752. 355170561123763/355533001123760. 355170561123888/355533001123885.355170561123904/35553300112390
1. 355170561123961/355533001123968. 355170561123979/355533001123976. 355170561123987/355533001123984. 355170561123995/35553300112
3992. 355170561124001/355533001124008. 355170561124175/355533001124172. 355170561124191/355533001124198. 355170561124225/35553300
1124222. 355170561124241/355533001124248. 355170561124308/355533001124305. 355170561124357/355533001124354. 355170561124381/35553
3001124388. 355170561124399/355533001124396. 355170561124407/355533001124404. 355170561124449/355533001124446. 355170561124456/35
5533001124453.355170561124464/355533001124461. 355170561124498/355533001124495. 355170561124506/355533001124503. 355170561125115/
355533001125112. 355170561125131/355533001125138. 355170561125149/355533001125146. 355170561125156/355533001125153. 3551705611251
64/355533001125161. 355170561125206/355533001125203. 355170561125230/355533001125237. 355170561125453/355533001125450. 3551705611
25461/355533001125468. 355170561125495/355533001125492. 355170561125503/355533001125500. 355170561125529/355533001125526. 3551705
61125537/355533001125534. 355170561125552/355533001125559. 355170561125560/355533001125567. 355170561125586/355533001125583. 3551
70561125685/355533001125682. 355170561125792/355533001125799. 355170561125875/355533001125872. 355170561125941/355533001125948. 3
55170561125982/355533001125989. 355170561125990/355533001125997. 355170561126030/355533001126037. 355170561126139/355533001126136
. 355170561126220/355533001126227. 355170561126295/355533001126292. 355170561126444/355533001126441. 355170561126477/355533001126
474. 355170561126493/355533001126490. 355170561126501/355533001126508. 355170561126618/355533001126615. 355170561126634/355533001
126631. 355170561126659/355533001126656. 355170561126683/355533001126680. 355170561126709/355533001126706. 355170561126717/355533
001126714. 355170561126725/355533001126722. 355170561126741/355533001126748. 355170561126816/355533001126813. 355170561126824/355
533001126821. 355170561126840/355533001126847. 355170561126865/355533001126862. 355170561126899/355533001126896. 355170561126923/
355533001126920. 355170561126931/355533001126938. 355170561126949/355533001126946. 355170561126956/355533001126953. 3551705611269
72/355533001126979. 355170561126980/355533001126987. 355170561127004/355533001127001.355170561127012/355533001127019. 35517056112
7061/355533001127068. 355170561127087/355533001127084. 355170561127095/355533001127092. 355170561127103/355533001127100. 35517056
1127129/355533001127126. 355170561127152/355533001127159. 355170561127178/355533001127175. 355170561127186/355533001127183. 35517
0561127194/355533001127191. 355170561127202/355533001127209. 355170561127251/355533001127258. 355170561127269/355533001127266. 35
5170561127277/355533001127274. 355170561127285/355533001127282. 355170561127327/355533001127324. 355170561127335/355533001127332.
355170561127350/355533001127357. 355170561127368/355533001127365. 355170561127392/355533001127399. 355170561127400/35553300112740
7. 355170561127509/355533001127506. 355170561127608/355533001127605. 355170561127640/355533001127647. 355170561127657/35553300112
7654. 355170561127665/355533001127662. 355170561127749/355533001127746. 355170561127756/355533001127753. 355170561127855/35553300
1127852. 355170561127988/355533001127985. 355170561128051/355533001128058. 355170561128085/355533001128082. 355170561128127/35553
3001128124. 355170561128176/355533001128173. 355170561128184/355533001128181. 355170561128218/355533001128215. 355170561128465/35
5533001128462. 355170561128507/355533001128504. 355170561128671/355533001128678. 355170561128838/355533001128835. 355170561128887
/355533001128884. 355170561128978/355533001128975. 355170561128986/355533001128983. 355170561129026/355533001129023. 355170561129
158/355533001129155. 355170561129273/355533001129270. 355170561129281/355533001129288. 355170561129406/355533001129403. 355170561
129448/355533001129445. 355170561129513/355533001129510. 355170561129521/355533001129528. 355170561129539/355533001129536. 355170
561129588/355533001129585. 355170561129646/355533001129643. 355170561129687/355533001129684. 355170561129711/355533001129718. 355
170561129752/355533001129759. 355170561129760/355533001129767. 355170561129802/355533001129809. 355170561129935/355533001129932.
355170561129950/355533001129957. 355170561129976/355533001129973. 355170561130024/355533001130021. 355170561130156/35553300113015
3. 355170561130214/355533001130211. 355170561130230/355533001130237. 355170561130248/355533001130245. 355170561130255/35553300113
0252. 355170561130313/355533001130310. 355170561130339/355533001130336.355170561130362/355533001130369. 355170561130412/355533001
130419. 355170561130453/355533001130450. 355170561130503/355533001130500. 355170561130545/355533001130542. 355170561130552/355533
001130559. 355170561130560/355533001130567. 355170561130586/355533001130583. 355170561130602/355533001130609. 355170561130628/355
533001130625. 355170561130636/355533001130633. 355170561130685/355533001130682. 355170561130719/355533001130716. 355170561130727/
355533001130724. 355170561130735/355533001130732. 355170561130743/355533001130740. 355170561130784/355533001130781.35517056113085
9/355533001130856. 355170561130867/355533001130864. 355170561130875/355533001130872. 355170561130883/355533001130880. 35517056113
0891/355533001130898. 355170561130909/355533001130906. 355170561130917/355533001130914. 355170561130925/355533001130922. 35517056
1130941/355533001130948. 355170561130958/355533001130955. 355170561130974/355533001130971. 355170561131089/355533001131086. 35517
0561131097/355533001131094. 355170561131105/355533001131102. 355170561131121/355533001131128. 355170561131162/355533001131169. 35
5170561131188/355533001131185. 355170561131196/355533001131193. 355170561131246/355533001131243. 355170561131352/355533001131359.
355170561131360/355533001131367. 355170561131378/355533001131375. 355170561131386/355533001131383. 355170561131394/3555330011313
91. 355170561131436/355533001131433. 355170561131451/355533001131458. 355170561131477/355533001131474. 355170561131527/3555330011
032024001246634-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001246634-8 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
31524. 355170561131576/355533001131573. 355170561131592/355533001131599. 355170561131626/355533001131623. 355170561131642/3555330
01131649. 355170561131659/355533001131656. 355170561131709/355533001131706. 355170561131758/355533001131755. 355170561131840/3555
33001131847. 355170561131873/355533001131870. 355170561131899/355533001131896. 355170561131907/355533001131904. 355170561131915/3
55533001131912. 355170561131923/355533001131920. 355170561131931/355533001131938. 355170561131949/355533001131946. 35517056113199
8/355533001131995. 355170561132004/355533001132001. 355170561132012/355533001132019. 355170561132020/355533001132027. 35517056113
2038/355533001132035. 355170561132046/355533001132043. 355170561132053/355533001132050. 355170561132079/355533001132076. 35517056
1132095/355533001132092. 355170561132103/355533001132100.355170561132111/355533001132118. 355170561132129/355533001132126. 355170
561132137/355533001132134. 355170561132145/355533001132142. 355170561132152/355533001132159. 355170561132194/355533001132191. 355
170561132210/355533001132217. 355170561132236/355533001132233. 355170561132277/355533001132274. 355170561132293/355533001132290.
355170561132301/355533001132308. 355170561132319/355533001132316. 355170561132327/355533001132324. 355170561132335/35553300113233
2. 355170561132343/355533001132340. 355170561132400/355533001132407. 355170561132426/355533001132423.355170561132434/355533001132
431. 355170561132442/355533001132449. 355170561132459/355533001132456. 355170561132467/355533001132464. 355170561132483/355533001
132480. 355170561132491/355533001132498. 355170561132525/355533001132522. 355170561132566/355533001132563. 355170561132574/355533
001132571. 355170561132582/355533001132589. 355170561132590/355533001132597. 355170561132640/355533001132647. 355170561132657/355
533001132654. 355170561132665/355533001132662. 355170561132673/355533001132670. 355170561132699/355533001132696. 355170561132707/
355533001132704. 355170561132715/355533001132712. 355170561132731/355533001132738. 355170561132780/355533001132787. 3551705611327
98/355533001132795. 355170561132814/355533001132811. 355170561132822/355533001132829. 355170561132830/355533001132837. 3551705611
32855/355533001132852. 355170561132897/355533001132894. 355170561132905/355533001132902. 355170561132913/355533001132910. 3551705
61132921/355533001132928. 355170561132970/355533001132977. 355170561133325/355533001133322. 355170561133333/355533001133330. 3551
70561133366/355533001133363. 355170561133374/355533001133371. 355170561133408/355533001133405. 355170561133424/355533001133421. 3
55170561133465/355533001133462. 355170561133473/355533001133470. 355170561133481/355533001133488. 355170561133499/355533001133496
. 355170561133507/355533001133504. 355170561133515/355533001133512. 355170561133523/355533001133520. 355170561133556/355533001133
553. 355170561133564/355533001133561. 355170561133580/355533001133587. 355170561133606/355533001133603. 355170561133614/355533001
133611. 355170561133630/355533001133637. 355170561133655/355533001133652. 355170561133663/355533001133660. 355170561133689/355533
001133686. 355170561133705/355533001133702.355170561133713/355533001133710. 355170561133721/355533001133728. 355170561133739/3555
33001133736. 355170561133747/355533001133744. 355170561133796/355533001133793. 355170561133804/355533001133801. 355170561133812/3
55533001133819. 355170561133820/355533001133827. 355170561133879/355533001133876. 355170561133895/355533001133892. 35517056113391
1/355533001133918. 355170561134455/355533001134452. 355170561134646/355533001134643. 355170561134703/355533001134700. 35517056113
4752/355533001134759. 355170561134786/355533001134783. 355170561134794/355533001134791.355170561134802/355533001134809. 355170561
134810/355533001134817. 355170561134851/355533001134858. 355170561134893/355533001134890. 355170561134901/355533001134908. 355170
561134927/355533001134924. 355170561134976/355533001134973. 355170561134984/355533001134981. 355170561134992/355533001134999. 355
170561135007/355533001135004. 355170561135015/355533001135012. 355170561135031/355533001135038. 355170561135049/355533001135046.
355170561135106/355533001135103. 355170561135114/355533001135111. 355170561135130/355533001135137. 355170561135148/35553300113514
5. 355170561135171/355533001135178. 355170561135197/355533001135194. 355170561135221/355533001135228. 355170561135247/35553300113
5244. 355170561135262/355533001135269. 355170561135288/355533001135285. 355170561135296/355533001135293. 355170561135312/35553300
1135319. 355170561135346/355533001135343. 355170561135528/355533001135525. 355170561135817/355533001135814. 355170561135940/35553
3001135947. 355170561135957/355533001135954. 355170561135965/355533001135962. 355170561135973/355533001135970. 355170561135981/35
5533001135988. 355170561136039/355533001136036. 355170561136088/355533001136085. 355170561136104/355533001136101. 355170561136120
/355533001136127. 355170561136146/355533001136143. 355170561136153/355533001136150. 355170561136161/355533001136168. 355170561136
179/355533001136176. 355170561136195/355533001136192. 355170561136203/355533001136200. 355170561136229/355533001136226. 355170561
136237/355533001136234. 355170561136252/355533001136259. 355170561136260/355533001136267. 355170561136278/355533001136275. 355170
561136294/355533001136291. 355170561136302/355533001136309. 355170561136310/355533001136317. 355170561136328/355533001136325. 355
170561136336/355533001136333.355170561136344/355533001136341. 355170561136351/355533001136358. 355170561136377/355533001136374. 3
55170561136385/355533001136382. 355170561136393/355533001136390. 355170561136401/355533001136408. 355170561136419/355533001136416
. 355170561136427/355533001136424. 355170561136468/355533001136465. 355170561136476/355533001136473. 355170561136492/355533001136
499. 355170561136567/355533001136564. 355170561136724/355533001136721. 355170561136732/355533001136739. 355170561136757/355533001
136754. 355170561136765/355533001136762. 355170561136773/355533001136770.355170561136799/355533001136796. 355170561136815/3555330
01136812. 355170561136831/355533001136838. 355170561136856/355533001136853. 355170561136864/355533001136861. 355170561136906/3555
33001136903. 355170561136955/355533001136952. 355170561136963/355533001136960. 355170561136971/355533001136978. 355170561137029/3
55533001137026. 355170561137045/355533001137042. 355170561137086/355533001137083. 355170561137094/355533001137091. 35517056113710
2/355533001137109. 355170561137110/355533001137117. 355170561137136/355533001137133. 355170561137144/355533001137141. 35517056113
7177/355533001137174. 355170561137227/355533001137224. 355170561137235/355533001137232. 355170561137243/355533001137240. 35517056
1137342/355533001137349. 355170561137359/355533001137356. 355170561137375/355533001137372. 355170561137383/355533001137380. 35517
0561137391/355533001137398. 355170561137409/355533001137406XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001246634-8
Espacio para uso exclusivo de la Entidad Recaudadora
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