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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
032024001247257-9
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. 734893023784 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 9102857954 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
154.00
500.00
78 .Valor FOB 79 . Valor fletes USD USD
49.607.58
933.65
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
936.10
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: 529989-DECL: 1837215-DO: 893120978241- 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: 3072685526. ID CONTEN
EDOR: 6077852283. 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 032024001247257
133. Feha: 202409 09
134 . Levante No. 032024001172150 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 92032406698983
Fecha presentación 2024-09-09 16:56:06 Valor pagado $0.00
Fecha de Impresión: 2024-09-09 16:56:15
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001247257-9 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: 355170561111875/355533001111872. 3551705611
11891/355533001111898. 355170561111917/355533001111914. 355170561111933/355533001111930. 355170561111958/355533001111955. 3551705
61111982/355533001111989. 355170561112014/355533001112011. 355170561112071/355533001112078. 355170561112105/355533001112102. 3551
70561112337/355533001112334. 355170561112345/355533001112342. 355170561112360/355533001112367. 355170561112410/355533001112417. 3
55170561112436/355533001112433. 355170561112444/355533001112441. 355170561112493/355533001112490. 355170561112519/355533001112516
. 355170561112576/355533001112573. 355170561112584/355533001112581. 355170561112592/355533001112599. 355170561112733/355533001112
730. 355170561113145/355533001113142. 355170561113152/355533001113159. 355170561113343/355533001113340. 355170561113442/355533001
113449. 355170561113772/355533001113779. 355170561113780/355533001113787. 355170561113806/3 55533001113803. 355170561113855/35553
3001113852. 355170561113889/355533001113886. 355170561113939/355533001113936. 355170561114366/355533001114363. 355170561114382/35
5533001114389. 355170561114408/355533001114405. 355170561114416/355533001114413. 355170561114481/355533001114488.355170561114499/
355533001114496. 355170561114507/355533001114504. 355170561114580/355533001114587. 355170561115140/355533001115147. 3551705611151
65/355533001115162. 355170561115173/355533001115170. 355170561115181/355533001115188. 355170561115199/355533001115196. 3551705611
15207/355533001115204. 355170561115223/355533001115220. 355170561115231/355533001115238. 355170561115256/355533001115253. 3551705
61115264/355533001115261. 355170561115272/355533001115279. 355170561115314/355533001115311. 355170561115322/355533001115329. 3551
70561115330/355533001115337.355170561115348/355533001115345. 355170561115355/355533001115352. 355170561115363/355533001115360. 35
5170561115397/355533001115394. 355170561115439/355533001115436. 355170561115447/355533001115444. 355170561115462/355533001115469.
355170561115488/355533001115485. 355170561115538/355533001115535. 355170561115546/355533001115543. 355170561115553/3555330011155
50. 355170561115561/355533001115568. 355170561115579/355533001115576. 355170561115595/355533001115592. 355170561115603/3555330011
15600. 355170561115611/355533001115618. 355170561115629/355533001115626. 355170561115645/355533001115642. 355170561115652/3555330
01115659. 355170561115660/355533001115667. 355170561115678/355533001115675. 355170561115728/355533001115725. 355170561115736/3555
33001115733. 355170561115744/355533001115741. 355170561115751/355533001115758. 355170561115769/355533001115766. 355170561115777/3
55533001115774. 355170561115819/355533001115816. 355170561115835/355533001115832. 355170561115876/355533001115873. 35517056111593
4/355533001115931. 355170561115959/355533001115956. 355170561116007/355533001116004. 355170561116056/355533001116053. 35517056111
6072/355533001116079. 355170561116080/355533001116087. 355170561116189/355533001116186. 355170561116833/355533001116830. 35517056
1117187/355533001117184. 355170561117203/355533001117200. 355170561118854/355533001118851. 355170561118870/355533001118877. 35517
0561118904/355533001118901. 355170561118920/355533001118927. 355170561119068/355533001119065. 355170561119142/355533001119149. 35
5170561119241/355533001119248. 355170561119522/355533001119529. 355170561119977/355533001119974. 355170561120041/355533001120048.
355170561120066/355533001120063. 355170561120116/355533001120113. 355170561120298/355533001120295.355170561120355/35553300112035
2. 355170561120363/355533001120360. 355170561120389/355533001120386. 355170561120405/355533001120402. 355170561120439/35553300112
0436. 355170561120454/355533001120451. 355170561120470/355533001120477. 355170561120488/355533001120485. 355170561120496/35553300
1120493. 355170561120512/355533001120519. 355170561120520/355533001120527. 355170561120538/355533001120535. 355170561120546/35553
3001120543. 355170561120561/355533001120568. 355170561120587/355533001120584. 355170561120637/355533001120634. 355170561120645/35
5533001120642.355170561120652/355533001120659. 355170561120686/355533001120683. 355170561120702/355533001120709. 355170561120751/
355533001120758. 355170561120785/355533001120782. 355170561120793/355533001120790. 355170561120801/355533001120808. 3551705611208
50/355533001120857. 355170561120991/355533001120998. 355170561062292/355533001062299. 355170561074073/355533001074070. 3551705610
77902/355533001077909. 355170561082787/355533001082784. 355170561096605/355533001096602. 355170561096647/355533001096644. 3551705
61096704/355533001096701. 355170561096712/355533001096719. 355170561096738/355533001096735. 355170561096944/355533001096941. 3551
70561097801/355533001097808. 355170561098494/355533001098491. 355170561098569/355533001098566. 355170561098635/355533001098632. 3
55170561098650/355533001098657. 355170561099401/355533001099408. 355170561099583/355533001099580. 355170561099815/355533001099812
. 355170561101488/355533001101485. 355170561101504/355533001101501. 355170561101520/355533001101527. 355170561101652/355533001101
659. 355170561103047/355533001103044. 355170561103054/355533001103051. 355170561109663/355533001109660. 355170561109689/355533001
109686. 355170561109747/355533001109744. 355170561109754/355533001109751. 355170561109770/355533001109777. 355170561110018/355533
001110015. 355170561110026/355533001110023. 355170561110059/355533001110056. 355170561110067/355533001110064. 355170561110091/355
533001110098. 355170561110109/355533001110106. 355170561110117/355533001110114. 355170561110125/355533001110122. 355170561110182/
355533001110189. 355170561110208/355533001110205. 355170561110257/355533001110254. 355170561110356/355533001110353. 3551705611103
80/355533001110387. 355170561110620/355533001110627. 355170561111198/355533001111195.355170561111206/355533001111203. 35517056111
1214/355533001111211. 355170561111230/355533001111237. 355170561111248/355533001111245. 355170561111313/355533001111310. 35517056
1111354/355533001111351. 355170561111370/355533001111377. 355170561111388/355533001111385. 355170561111404/355533001111401. 35517
0561111412/355533001111419. 355170561111420/355533001111427. 355170561111438/355533001111435. 355170561111453/355533001111450. 35
5170561111479/355533001111476. 355170561111487/355533001111484. 355170561111495/355533001111492. 355170561111511/355533001111518.
355170561111529/355533001111526. 355170561111537/355533001111534. 355170561111545/355533001111542. 355170561111552/35553300111155
9. 355170561111560/355533001111567. 355170561111578/355533001111575. 355170561111586/355533001111583. 355170561111594/35553300111
1591. 355170561111602/355533001111609. 355170561111610/355533001111617. 355170561111628/355533001111625. 355170561111636/35553300
1111633. 355170561111644/355533001111641. 355170561111651/355533001111658. 355170561111669/355533001111666. 355170561111677/35553
3001111674. 355170561111685/355533001111682. 355170561111693/355533001111690. 355170561111701/355533001111708. 355170561111727/35
5533001111724. 355170561111735/355533001111732. 355170561111776/355533001111773. 355170561111792/355533001111799. 355170561111800
/355533001111807. 355170561111818/355533001111815. 355170561111834/355533001111831. 355170561111859/355533001111856. 355170561121
049/355533001121046. 355170561121122/355533001121129. 355170561121239/355533001121236. 355170561121247/355533001121244. 355170561
121346/355533001121343. 355170561121437/355533001121434. 355170561121452/355533001121459. 355170561121478/355533001121475. 355170
561121494/355533001121491. 355170561121544/355533001121541. 355170561121585/355533001121582. 355170561121635/355533001121632. 355
170561121643/355533001121640. 355170561121650/355533001121657. 355170561121668/355533001121665. 355170561121676/355533001121673.
355170561121692/355533001121699. 355170561121718/355533001121715. 355170561121726/355533001121723. 355170561121734/35553300112173
1. 355170561121742/355533001121749. 355170561121759/355533001121756. 355170561121767/355533001121764. 355170561121775/35553300112
1772. 355170561121783/355533001121780. 355170561121791/355533001121798.355170561121809/355533001121806. 355170561122070/355533001
122077. 355170561122989/355533001122986. 355170561123110/355533001123117. 355170561123250/355533001123257. 355170561123326/355533
001123323. 355170561123342/355533001123349. 355170561123375/355533001123372. 355170561123409/355533001123406. 355170561123425/355
533001123422. 355170561123466/355533001123463. 355170561123482/355533001123489. 355170561123524/355533001123521. 355170561123532/
355533001123539. 355170561123540/355533001123547. 355170561123607/355533001123604. 355170561123631/355533001123638.35517056112364
9/355533001123646. 355170561123698/355533001123695. 355170561123706/355533001123703. 355170561123813/355533001123810. 35517056112
3821/355533001123828. 355170561123839/355533001123836. 355170561123847/355533001123844. 355170561123870/355533001123877. 35517056
1124266/355533001124263. 355170561124431/355533001124438. 355170561124589/355533001124586. 355170561124829/355533001124826. 35517
0561125073/355533001125070. 355170561125222/355533001125229. 355170561125255/355533001125252. 355170561125263/355533001125260. 35
5170561125271/355533001125278. 355170561125289/355533001125286. 355170561125305/355533001125302. 355170561125313/355533001125310.
355170561125370/355533001125377. 355170561125412/355533001125419. 355170561125594/355533001125591. 355170561125610/3555330011256
17. 355170561125651/355533001125658. 355170561125693/355533001125690. 355170561125719/355533001125716. 355170561125735/3555330011
032024001247257-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001247257-9 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
25732. 355170561125743/355533001125740. 355170561125750/355533001125757. 355170561125768/355533001125765. 355170561125776/3555330
01125773. 355170561125818/355533001125815. 355170561125826/355533001125823. 355170561125917/355533001125914. 355170561125925/3555
33001125922. 355170561125933/355533001125930. 355170561125958/355533001125955. 355170561126006/355533001126003. 355170561126105/3
55533001126102. 355170561126246/355533001126243. 355170561126253/355533001126250. 355170561126329/355533001126326. 35517056112640
2/355533001126409. 355170561126436/355533001126433. 355170561126485/355533001126482. 355170561126592/355533001126599. 35517056112
6600/355533001126607. 355170561127046/355533001127043. 355170561127525/355533001127522. 355170561127533/355533001127530. 35517056
1128200/355533001128207. 355170561128283/355533001128280.355170561128291/355533001128298. 355170561128317/355533001128314. 355170
561128705/355533001128702. 355170561128770/355533001128777. 355170561129562/355533001129569. 355170561129596/355533001129593. 355
170561129695/355533001129692. 355170561129703/355533001129700. 355170561129729/355533001129726. 355170561129737/355533001129734.
355170561129778/355533001129775. 355170561129836/355533001129833. 355170561129968/355533001129965. 355170561130008/35553300113000
5. 355170561130016/355533001130013. 355170561130040/355533001130047. 355170561130065/355533001130062.355170561130081/355533001130
088. 355170561130099/355533001130096. 355170561130107/355533001130104. 355170561130354/355533001130351. 355170561130396/355533001
130393. 355170561130446/355533001130443. 355170561130529/355533001130526. 355170561130537/355533001130534. 355170561130578/355533
001130575. 355170561130669/355533001130666. 355170561130677/355533001130674. 355170561130834/355533001130831. 355170561130990/355
533001130997. 355170561131139/355533001131136. 355170561131154/355533001131151. 355170561131303/355533001131300. 355170561131402/
355533001131409. 355170561131493/355533001131490. 355170561131501/355533001131508. 355170561131618/355533001131615. 3551705611317
74/355533001131771. 355170561131816/355533001131813. 355170561131956/355533001131953. 355170561131972/355533001131979. 3551705611
32061/355533001132068. 355170561132806/355533001132803. 355170561133531/355533001133538. 355170561133671/355533001133678. 3551705
61133853/355533001133850. 355170561134000/355533001134007. 355170561134240/355533001134247. 355170561134588/355533001134585. 3551
70561134604/355533001134601. 355170561134711/355533001134718. 355170561134737/355533001134734. 355170561134885/355533001134882. 3
55170561135254/355533001135251. 355170561135395/355533001135392. 355170561135544/355533001135541. 355170561135569/355533001135566
. 355170561135809/355533001135806. 355170561135890/355533001135897. 355170561136021/355533001136028. 355170561136187/355533001136
184. 355170561136443/355533001136440. 355170561136450/355533001136457. 355170561136484/355533001136481. 355170561136690/355533001
136697. 355170561136807/355533001136804. 355170561137300/355533001137307. 355170561137367/355533001137364. 355170561137458/355533
001137455. 355170561137466/355533001137463.355170561137474/355533001137471. 355170561137508/355533001137505. 355170561137631/3555
33001137638. 355170561137961/355533001137968. 355170561137987/355533001137984. 355170561138076/355533001138073. 355170561154503/3
55533001154500. 355170561160708/355533001160705. 355170561160807/355533001160804. 355170561160815/355533001160812. 35517056116082
3/355533001160820. 355170561164643/355533001164640. 355170561164676/355533001164673. 355170561164684/355533001164681. 35517056116
4882/355533001164889. 355170561165038/355533001165035. 355170561165277/355533001165274.355170561165301/355533001165308. 355170561
165319/355533001165316. 355170561165350/355533001165357. 355170561165368/355533001165365. 355170561165400/355533001165407. 355170
561165442/355533001165449. 355170561168487/355533001168484. 355170561171614/355533001171611. 355170561171721/355533001171728. 355
170561171739/355533001171736. 355170561171887/355533001171884. 355170561171929/355533001171926. 355170561171960/355533001171967.
355170561171978/355533001171975. 355170561171986/355533001171983. 355170561172117/355533001172114. 355170561172182/35553300117218
9. 355170561172216/355533001172213. 355170561172224/355533001172221. 355170561172232/355533001172239. 355170561172240/35553300117
2247. 355170561172257/355533001172254. 355170561172265/355533001172262. 355170561172281/355533001172288. 355170561172299/35553300
1172296. 355170561172307/355533001172304. 355170561172315/355533001172312. 355170561172323/355533001172320. 355170561172331/35553
3001172338. 355170561172356/355533001172353. 355170561172372/355533001172379. 355170561172398/355533001172395. 355170561172414/35
5533001172411. 355170561172430/355533001172437. 355170561172448/355533001172445. 355170561172489/355533001172486. 355170561172505
/355533001172502. 355170561172521/355533001172528. 355170561172562/355533001172569. 355170561172604/355533001172601. 355170561172
620/355533001172627. 355170561172661/355533001172668. 355170561172695/355533001172692. 355170561172711/355533001172718. 355170561
172729/355533001172726. 355170561172737/355533001172734. 355170561172745/355533001172742. 355170561172786/355533001172783. 355170
561172802/355533001172809. 355170561172810/355533001172817. 355170561172828/355533001172825. 355170561172851/355533001172858. 355
170561172877/355533001172874.355170561173008/355533001173005. 355170561173016/355533001173013. 355170561173032/355533001173039. 3
55170561173107/355533001173104. 355170561173156/355533001173153. 355170561173164/355533001173161. 355170561173388/355533001173385
. 355170561173420/355533001173427. 355170561173438/355533001173435. 355170561173453/355533001173450. 355170561173479/355533001173
476. 355170561173701/355533001173708. 355170561173768/355533001173765. 355170561173826/355533001173823. 355170561173883/355533001
173880. 355170561173909/355533001173906. 355170561173958/355533001173955.355170561174790/355533001174797. 355170561174956/3555330
01174953. 355170561175086/355533001175083. 355170561175110/355533001175117. 355170561175136/355533001175133. 355170561175151/3555
33001175158. 355170561175185/355533001175182. 355170561175193/355533001175190. 355170561175201/355533001175208. 355170561175219/3
55533001175216. 355170561175227/355533001175224. 355170561175235/355533001175232. 355170561175243/355533001175240. 35517056117526
8/355533001175265. 355170561175276/355533001175273. 355170561175284/355533001175281. 355170561175300/355533001175307. 35517056117
5359/355533001175356. 355170561175367/355533001175364. 355170561175425/355533001175422. 355170561175482/355533001175489. 35517056
1175524/355533001175521. 355170561175672/355533001175679. 355170561175748/355533001175745. 355170561183288/355533001183285. 35517
0561183296/355533001183293. 355170561183312/355533001183319XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001247257-9
Espacio para uso exclusivo de la Entidad Recaudadora
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