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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
032024001230499-1
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. 116575014736123 2024 – 09 – 04 No. SHAN0342002 2024 – 08 – 31
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 9102850969 2024 – 08 – 31 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
580
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. DHL AERO EXPRESO S A SUCURSAL COLOMBIA
4.132.11
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
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
49.927.49
1.107.77
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
2.47
0
Arancel
0
0
0.00
92 93 94 0.00 210.893.515
95
96
I.V.A.
9798 99 100 101
0.00 210.893.515 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.110.24
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
51.037.73
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: 529529-DECL: 1836357-DO: 893120618241- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN)// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCAN
CIA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3072686045. ID CONTENED
OR: 6077756279. MERCANCIA MARCA: SAMSUNGREFERENCIA: SM-A155MZKILTC, PRODUCTO: TELEFONO CELULAR GALAXY A15 5G DUOS, (CON ACCESORIO
S PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO,MODELO: SM-A155M/DSN, USO O DESTINO: PARA LA VENTA AL MAY(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 032024001230499
133. Feha: 202409 05
134 . Levante No. 032024001155579 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 05
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 92032406614612
Fecha presentación 2024-09-05 12:45:14 Valor pagado $0.00
Fecha de Impresión: 2024-09-05 12:45:20
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001230499-1 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
OR Y AL DETAL/ /MOBILE,SM-A155M/DSN,BLACK,LTC( QTY. 500,00 u )(500,00 PCE); IMEIS:355170561079684/355533001079681. 35517056107983
3/355533001079830. 355170561079874/355533001079871. 355170561079882/355533001079889. 355170561079890/355533001079897. 35517056107
9908/355533001079905. 355170561079924/355533001079921. 355170561079940/355533001079947. 355170561080062/355533001080069. 35517056
1080179/355533001080176. 355170561080203/355533001080200. 355170561080211/355533001080218. 355170561080328/355533001080325. 35517
0561080369/355533001080366. 355170561080484/355533001080481. 355170561080542/355533001080549. 355170561081540/355533001081547.355
170561081870/355533001081877. 355170561082159/355533001082156. 355170561082191/355533001082198. 355170561082217/355533001082214.
355170561082266/355533001082263. 355170561082290/355533001082297. 355170561082316/355533001082313. 355170561082324/35553300108232
1. 355170561082340/355533001082347. 355170561082357/355533001082354. 355170561082373/355 533001082370. 355170561082431/3555330010
82438. 355170561082449/355533001082446. 355170561082456/355533001082453. 355170561082464/355533001082461. 355170561082548/3555330
01082545. 355170561082563/355533001082560. 355170561082571/355533001082578. 355170561082589/355533001082586. 355170561082597/3555
33001082594. 355170561082621/355533001082628. 355170561082662/355533001082669. 355170561082670/355533001082677. 355170561082696/3
55533001082693. 355170561082704/355533001082701. 355170561082720/355533001082727. 355170561082738/355533001082735. 35517056108274
6/355533001082743. 355170561082753/355533001082750. 355170561082761/355533001082768. 355170561082779/355533001082776. 35517056108
2795/355533001082792. 355170561082803/355533001082800. 355170561082829/355533001082826. 355170561082837/355533001082834. 35517056
1082860/355533001082867. 355170561082902/355533001082909. 355170561083116/355533001083113. 355170561083157/355533001083154. 35517
0561083173/355533001083170. 355170561083223/355533001083220. 355170561083371/355533001083378. 355170561083389/355533001083386. 35
5170561083405/355533001083402. 355170561083413/355533001083410. 355170561083421/355533001083428. 355170561083447/355533001083444.
355170561083454/355533001083451. 355170561083470/355533001083477. 355170561083488/355533001083485. 355170561083496/3555330010834
93. 355170561083504/355533001083501. 355170561083512/355533001083519.355170561083520/355533001083527. 355170561083538/35553300108
3535. 355170561083553/355533001083550. 355170561083561/355533001083568. 355170561083645/355533001083642. 355170561083702/35553300
1083709. 355170561083710/355533001083717. 355170561083751/355533001083758. 355170561083777/355533001083774. 355170561083793/35553
3001083790. 355170561083801/355533001083808. 355170561083819/355533001083816. 355170561083835/355533001083832. 355170561083843/35
5533001083840. 355170561083868/355533001083865. 355170561083967/355533001083964. 355170561084023/355533001084020.355170561084031/
355533001084038. 355170561084098/355533001084095. 355170561084106/355533001084103. 355170561084205/355533001084202. 3551705610842
13/355533001084210. 355170561084221/355533001084228. 355170561084239/355533001084236. 355170561084247/355533001084244. 3551705610
84254/355533001084251. 355170561084262/355533001084269. 355170561084296/355533001084293. 355170561084304/355533001084301. 3551705
61084312/355533001084319. 355170561084338/355533001084335. 355170561084346/355533001084343. 355170561084817/355533001084814. 3551
70561084825/355533001084822. 355170561084874/355533001084871. 355170561085178/355533001085175. 355170561085186/355533001085183. 3
55170561085194/355533001085191. 355170561085202/355533001085209. 355170561085210/355533001085217. 355170561085228/355533001085225
. 355170561085269/355533001085266. 355170561085285/355533001085282. 355170561085293/355533001085290. 355170561085392/355533001085
399. 355170561085418/355533001085415. 355170561085426/355533001085423. 355170561085434/355533001085431. 355170561085442/355533001
085449. 355170561085459/355533001085456. 355170561085467/355533001085464. 355170561085541/355533001085548. 355170561085582/355533
001085589. 355170561085665/355533001085662. 355170561085806/355533001085803. 355170561086085/355533001086082. 355170561086101/355
533001086108. 355170561086259/355533001086256. 355170561086267/355533001086264. 355170561086283/355533001086280. 355170561086309/
355533001086306. 355170561086325/355533001086322. 355170561086333/355533001086330. 355170561096415/355533001096412. 3551705610964
80/355533001096487. 355170561096522/355533001096529. 355170561096555/355533001096552. 355170561096563/355533001096560. 3551705610
96571/355533001096578. 355170561096597/355533001096594.355170561096654/355533001096651. 355170561096670/355533001096677. 35517056
1096688/355533001096685. 355170561096795/355533001096792. 355170561096803/355533001096800. 355170561096811/355533001096818. 35517
0561096829/355533001096826. 355170561096910/355533001096917. 355170561096951/355533001096958. 355170561096977/355533001096974. 35
5170561097041/355533001097048. 355170561097066/355533001097063. 355170561097090/355533001097097. 355170561097223/355533001097220.
355170561097264/355533001097261. 355170561097298/355533001097295. 355170561097322/355533001097329.355170561097330/35553300109733
7. 355170561097348/355533001097345. 355170561097363/355533001097360. 355170561097371/355533001097378. 355170561097389/35553300109
7386. 355170561097397/355533001097394. 355170561097405/355533001097402. 355170561097413/355533001097410. 355170561097421/35553300
1097428. 355170561097447/355533001097444. 355170561097454/355533001097451. 355170561097462/355533001097469. 355170561097470/35553
3001097477. 355170561097488/355533001097485. 355170561097504/355533001097501. 355170561097512/355533001097519. 355170561097520/35
5533001097527. 355170561097546/355533001097543. 355170561097553/355533001097550. 355170561097595/355533001097592. 355170561097611
/355533001097618. 355170561097637/355533001097634. 355170561097645/355533001097642. 355170561097660/355533001097667. 355170561097
728/355533001097725. 355170561097744/355533001097741. 355170561097769/355533001097766. 355170561097777/355533001097774. 355170561
097785/355533001097782. 355170561097850/355533001097857. 355170561097868/355533001097865. 355170561097926/355533001097923. 355170
561097991/355533001097998. 355170561098015/355533001098012. 355170561098023/355533001098020. 355170561098106/355533001098103. 355
170561098122/355533001098129. 355170561098130/355533001098137. 355170561098148/355533001098145. 355170561098155/355533001098152.
355170561098163/355533001098160. 355170561098171/355533001098178. 355170561098304/355533001098301. 355170561098312/35553300109831
9. 355170561098346/355533001098343. 355170561098445/355533001098442. 355170561098478/355533001098475. 355170561098551/35553300109
8558. 355170561098601/355533001098608. 355170561098619/355533001098616. 355170561098676/355533001098673. 355170561098684/35553300
1098681. 355170561098791/355533001098798.355170561098841/355533001098848. 355170561099088/355533001099085. 355170561099112/355533
001099119. 355170561099138/355533001099135. 355170561099146/355533001099143. 355170561099153/355533001099150. 355170561099161/355
533001099168. 355170561099187/355533001099184. 355170561099195/355533001099192. 355170561099203/355533001099200. 355170561099229/
355533001099226. 355170561099237/355533001099234. 355170561099252/355533001099259. 355170561099260/355533001099267. 3551705610992
78/355533001099275. 355170561099286/355533001099283. 355170561099336/355533001099333.355170561099344/355533001099341. 35517056109
9351/355533001099358. 355170561099377/355533001099374. 355170561099385/355533001099382. 355170561099443/355533001099440. 35517056
1099450/355533001099457. 355170561099468/355533001099465. 355170561099476/355533001099473. 355170561099518/355533001099515. 35517
0561099534/355533001099531. 355170561099542/355533001099549. 355170561099559/355533001099556. 355170561099575/355533001099572. 35
5170561099641/355533001099648. 355170561100381/355533001100388. 355170561100613/355533001100610. 355170561101355/355533001101352.
355170561101421/355533001101428. 355170561101496/355533001101493. 355170561101587/355533001101584. 355170561101603/3555330011016
00. 355170561101611/355533001101618. 355170561101629/355533001101626. 355170561101637/355533001101634. 355170561101645/3555330011
01642. 355170561101686/355533001101683. 355170561101736/355533001101733. 355170561101751/355533001101758. 355170561101769/3555330
01101766. 355170561101777/355533001101774. 355170561101793/355533001101790. 355170561101801/355533001101808. 355170561101827/3555
33001101824. 355170561101850/355533001101857. 355170561101876/355533001101873. 355170561101900/355533001101907. 355170561101991/3
55533001101998. 355170561102056/355533001102053. 355170561102064/355533001102061. 355170561102072/355533001102079. 35517056118322
1/355533001183228. 355170561183239/355533001183236. 355170561183247/355533001183244. 355170561183262/355533001183269. 35517056118
3270/355533001183277. 355170561183304/355533001183301. 355170561183361/355533001183368. 355170561183379/355533001183376. 35517056
1183395/355533001183392. 355170561183429/355533001183426. 355170561183452/355533001183459. 355170561102098/355533001102095. 35517
0561102122/355533001102129.355170561102130/355533001102137. 355170561102148/355533001102145. 355170561102197/355533001102194. 355
170561102205/355533001102202. 355170561102213/355533001102210. 355170561102221/355533001102228. 355170561102247/355533001102244.
355170561102288/355533001102285. 355170561102296/355533001102293. 355170561102304/355533001102301. 355170561102312/35553300110231
032024001230499-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001230499-1 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
9. 355170561102320/355533001102327. 355170561102338/355533001102335. 355170561102346/355533001102343. 355170561102353/35553300110
2350. 355170561102403/355533001102400. 355170561102411/355533001102418.355170561102437/355533001102434. 355170561102445/355533001
102442. 355170561102452/355533001102459. 355170561102551/355533001102558. 355170561102569/355533001102566. 355170561102577/355533
001102574. 355170561102718/355533001102715. 355170561102759/355533001102756. 355170561102791/355533001102798. 355170561102866/355
533001102863. 355170561102924/355533001102921. 355170561102981/355533001102988. 355170561102999/355533001102996. 355170561103005/
355533001103002. 355170561103013/355533001103010. 355170561103021/355533001103028. 355170561103039/355533001103036. 3551705611031
12/355533001103119. 355170561103120/355533001103127. 355170561103146/355533001103143. 355170561103286/355533001103283. 3551705611
03393/355533001103390. 355170561103476/355533001103473. 355170561105133/355533001105130. 355170561183197/355533001183194. 3551705
60964548/355533000964545. 355170561055924/355533001055921. 355170561056013/355533001056010. 355170561056252/355533001056259. 3551
70561056260/355533001056267. 355170561056435/355533001056432. 355170561056484/355533001056481. 355170561057284/355533001057281. 3
55170561057649/355533001057646. 355170561058167/355533001058164. 355170561059165/355533001059162. 355170561059306/355533001059303
. 355170561060486/355533001060483. 355170561062060/355533001062067. 355170561062276/355533001062273. 355170561062482/355533001062
489. 355170561062490/355533001062497. 355170561062508/355533001062505. 355170561062532/355533001062539. 355170561062565/355533001
062562. 355170561062581/355533001062588. 355170561062599/355533001062596. 355170561062615/355533001062612. 355170561062623/355533
001062620. 355170561062664/355533001062661. 355170561062680/355533001062687. 355170561062722/355533001062729. 355170561062730/355
533001062737.355170561062748/355533001062745. 355170561062771/355533001062778. 355170561062813/355533001062810. 355170561062854/3
55533001062851. 355170561062904/355533001062901. 355170561062946/355533001062943. 355170561063027/355533001063024. 35517056106304
3/355533001063040. 355170561063084/355533001063081. 355170561063118/355533001063115. 355170561063191/355533001063198. 35517056106
3415/355533001063412. 355170561063506/355533001063503. 355170561063738/355533001063735. 355170561063753/355533001063750. 35517056
1064009/355533001064006. 355170561065204/355533001065201.355170561066814/355533001066811. 355170561067077/355533001067074. 355170
561067085/355533001067082. 355170561067119/355533001067116. 355170561067135/355533001067132. 355170561067143/355533001067140. 355
170561067150/355533001067157. 355170561067200/355533001067207. 355170561067234/355533001067231. 355170561067275/355533001067272.
355170561067366/355533001067363. 355170561067408/355533001067405. 355170561067424/355533001067421. 355170561067440/35553300106744
7. 355170561067465/355533001067462. 355170561067515/355533001067512. 355170561067523/355533001067520. 355170561067655/35553300106
7652. 355170561067663/355533001067660. 355170561067721/355533001067728. 355170561067804/355533001067801. 355170561067903/35553300
1067900. 355170561068075/355533001068072. 355170561068117/355533001068114. 355170561068257/355533001068254. 355170561069172/35553
3001069179. 355170561069222/355533001069229. 355170561070964/355533001070961. 355170561071079/355533001071076. 355170561071137/35
5533001071134. 355170561071202/355533001071209. 355170561071210/355533001071217. 355170561071236/355533001071233. 355170561071269
/355533001071266. 355170561072077/355533001072074. 355170561072127/355533001072124. 355170561072176/355533001072173. 355170561072
184/355533001072181. 355170561072192/355533001072199. 355170561072200/355533001072207. 355170561072226/355533001072223. 355170561
072234/355533001072231. 355170561072242/355533001072249. 355170561072267/355533001072264. 355170561072291/355533001072298. 355170
561072317/355533001072314. 355170561072333/355533001072330. 355170561072358/355533001072355. 355170561072366/355533001072363. 355
170561072382/355533001072389. 355170561072408/355533001072405. 355170561072424/355533001072421. 355170561072440/355533001072447.3
55170561072473/355533001072470. 355170561072481/355533001072488. 355170561072515/355533001072512. 355170561072549/355533001072546
. 355170561072556/355533001072553. 355170561072564/355533001072561. 355170561072655/355533001072652. 355170561073000/355533001073
007. 355170561073083/355533001073080. 355170561073091/355533001073098. 355170561073117/355533001073114. 355170561073125/355533001
073122. 355170561073141/355533001073148. 355170561073158/355533001073155. 355170561073166/355533001073163. 355170561073174/355533
001073171. 355170561073232/355533001073239.355170561073257/355533001073254. 355170561073281/355533001073288. 355170561073307/3555
33001073304. 355170561073315/355533001073312. 355170561073331/355533001073338. 355170561073349/355533001073346. 355170561073356/3
55533001073353. 355170561073364/355533001073361. 355170561073372/355533001073379. 355170561073398/355533001073395. 35517056107341
4/355533001073411. 355170561073422/355533001073429. 355170561073430/355533001073437. 355170561073455/355533001073452. 35517056107
3851/355533001073858. 355170561073885/355533001073882. 355170561073893/355533001073890. 355170561073901/355533001073908. 35517056
1073968/355533001073965. 355170561073976/355533001073973. 355170561073992/355533001073999. 355170561074016/355533001074013. 35517
0561074024/355533001074021. 355170561074032/355533001074039. 355170561075849/355533001075846. 355170561076177/355533001076174. 35
5170561076284/355533001076281. 355170561076342/355533001076349. 355170561076433/355533001076430. 355170561076474/355533001076471.
355170561076540/355533001076547. 355170561076557/355533001076554. 355170561076599/355533001076596. 355170561076607/3555330010766
04. 355170561076623/355533001076620. 355170561076631/355533001076638. 355170561076649/355533001076646. 355170561076656/3555330010
76653. 355170561076672/355533001076679. 355170561076698/355533001076695. 355170561076730/355533001076737. 355170561076748/3555330
01076745. 355170561076763/355533001076760. 355170561077472/355533001077479. 355170561077498/355533001077495. 355170561077555/3555
33001077552. 355170561077571/355533001077578. 355170561077597/355533001077594. 355170561077605/355533001077602. 355170561077613/3
55533001077610. 355170561077639/355533001077636. 355170561077647/355533001077644. 355170561077795/355533001077792.355170561077928
/355533001077925. 355170561077969/355533001077966. 355170561078033/355533001078030. 355170561078090/355533001078097. 355170561078
116/355533001078113. 355170561078249/355533001078246. 355170561078264/355533001078261. 355170561079536/355533001079533. 355170561
079593/355533001079590. 355170561079635/355533001079632XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001230499-1
Espacio para uso exclusivo de la Entidad Recaudadora
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