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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
032024001649177-3
5 . Número de Identificación Tributaria (NIT)
830028931
6 . DV.
5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
13 . Dirección
CR 7 113 43 OF 607
15 . Teléfono
4870707
12 . Cód. Admón.
03
16 . Cód. Dpto
11
17 . Cód. Ciudad Municipio
001
24 . Número de Identificación Tributaria (NIT)
860536003
25 . DV.
3
26 . Razón social del declarante autorizado
AGENCIA DE ADUANAS ABC REPECEV S.A.S. NIVEL 1
27 . Tipo usuario
26
28 . Cód. usuario
99
29 . Número documento de identificación
102294385
30 . Apellidos y nombres
CARLOS ANDRES ROJAS MATAJUDIOS
31 . Clase
Importador
02
32 . Tipo declaración
Inicial
33 . Cod.
1
34 .No.Formulario Anterior
XXXXXXXXXXXXXX
35 . Año – Mes – Día
XXXX – XX – XX
36 . Cod. Admón.
XX
37 . Declaración de Exportación
No. XXXXXXXXXXXXXXX
38 . Año – Mes – Día
XXXX – XX – XX
39 . Cod. Admón.
XX
40 . Cod. lugar ingreso
de las mercancías
BOG
41 . Cod. Depósito
99900
42 . Manifiesto de carga
No. 116575015004718
43 . Año – Mes – Día
2024 – 11 – 22
44 . Documento de transporte
No. SHAN0358501
45 . Año – Mes – Día
2024 – 11 – 14
46 . Nombre exportador o proveedor en el exterior
SAMSUNG ELECTRONICS CO., LTD
47 . Ciudad
GYEONGGI-DO
48 . Cod.País Exportador
190
49 . Dirección exportador o proveedor en el exterior
129, SAMSUNG-RO, YEONGTONG-GU SUWON 16677
50 . E-mail
010-8705-6749
51 . No. de factura
9103025294
52 . Año – Mes – Día
2024 – 11 – 14
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
580
56 . Cod. Depto
destino
0
57 . Empresa transportadora
DHL AERO EXPRESO S A SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.387.09
S 59 . Subpartida arancelaria
8517130000
60 . Cod.
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
de origen
855
67 . Cod. Acuerdo
XXX
68 . Forma de pago
de la importación
01
69 . Tipo de
importación
01
70 . Cod. país
compra
190
71 . Peso bruto kgs. dcms.
106.50
72 . Peso neto kgs. dcms.
84.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
300.00
78 .Valor FOB
USD
49.140.53
79 . Valor fletes USD
1.031.99 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
220.122.021
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
220.122.021
99
0
100
0
101
0.00
Salvaguardia
102
0.00
103
0
104
0
105
0
106
0.00
Derechos
Compensatorios
107
0.00
108
0
109
0
110
0
111
0.00
Derechos
Antidumping
112
0.00
113
0
114
0
115
0
116
0.00
Sancion
117
0
118
0
119
0
120
0
Rescate
121
0
122
0
123
0
124
0
Total 125
0
126
0.00
80 . Valor Seguros
USD
2.43
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.034.42
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
50.174.95
85 . Código registro
o licencia
X
86 . Número
XXXXXXXXXX
87 .
Cod.
oficina
99
88 . Año
XXXX
89 . Programa No
XXXXXXXXXX
90 . Cód Interno del
Producto
0
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: 539123-DECL: 1861335-DO: 893127678241- 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: 3078058092. ID DELIVERY: 6079041361. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A356EZKGLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A35 5G 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
032024001649177
133. Feha: 202411 25
134 . Levante No. 032024001547473 135 . Fecha
2024 – 11 – 25
Firma funcionario responsable 136 . Nombre
137 . C.C. No.
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 92032408803851
Fecha presentación 2024-11-25 16:45:20
Valor pagado $0.00
Fecha de Impresión: 2024-11-25 16:45:30
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001649177-3
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A356E/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A356E/DS,BLACK,LTC( QTY. 300,00 u )(300,00 PCE);
IMEIS: 351676567100310/357896817100316. 351676567100336/357896817100332. 351676567100344/357896817100340. 351676567100351/357896
817100357. 351676567100377/357896817100373. 351676567100385/357896817100381. 351676567100393/357896817100399. 351676567100427/357
896817100423. 351676567100443/357896817100449. 351676567100633/357896817100639. 351676567101367/357896817101363. 351676567101391/
357896817101397. 351676567101409/357896817101405. 351676567101425/357896817101421. 351676567101896/357896817101892. 3516765671019
61/357896817101967. 351676567102860/357896817102866. 351676567102894/357896817102890. 351676567103371/357896817103377. 3516765671
03397/357896817103393. 351676567103504/357896817103500. 351676567103512/357896817103518. 351676567103538/357896817103534. 3516765
67103546/357896817103542. 351676567103561/357896817103567. 351676567103579/357896817103575. 3 51676567103587/357896817103583. 351
676567103611/357896817103617. 351676567103702/357896817103708. 351676567103736/357896817103732. 351676567103751/357896817103757.
351676567103769/357896817103765. 351676567103835/357896817103831. 351676567103843/357896817103849. 351676567103876/35789681710387
2. 351676567103892/357896817103898. 351676567103967/357896817103963. 351676567103991/357896817103997. 351676567104064/35789681710
4060. 351676567104080/357896817104086. 351676567104098/357896817104094. 351676567104114/357896817104110. 351676567104122/35789681
7104128.351676567104148/357896817104144. 351676566842672/357896816842678. 351676566874931/357896816874937. 351676566940864/357896
816940860. 351676567037322/357896817037328. 351676567037330/357896817037336. 351676567037348/357896817037344. 351676567093762/357
896817093768. 351676567094828/357896817094824. 351676567094869/357896817094865. 351676567094885/357896817094881. 351676567094893/
357896817094899. 351676567094901/357896817094907. 351676567094919/357896817094915. 351676567094984/357896817094980. 3516765670950
15/357896817095011. 351676567095049/357896817095045.351676567095056/357896817095052. 351676567095080/357896817095086. 35167656709
5106/357896817095102. 351676567095114/357896817095110. 351676567095130/357896817095136. 351676567095148/357896817095144. 35167656
7095155/357896817095151. 351676567095163/357896817095169. 351676567095171/357896817095177. 351676567095189/357896817095185. 35167
6567095197/357896817095193. 351676567095205/357896817095201. 351676567095213/357896817095219. 351676567095221/357896817095227. 35
1676567095239/357896817095235. 351676567095247/357896817095243. 351676567095254/357896817095250. 351676567095270/357896817095276.
351676567095288/357896817095284. 351676567095320/357896817095326. 351676567095346/357896817095342. 351676567095379/3578968170953
75. 351676567095395/357896817095391. 351676567095403/357896817095409. 351676567095429/357896817095425. 351676567095437/3578968170
95433. 351676567095445/357896817095441. 351676567095452/357896817095458. 351676567097714/357896817097710. 351676567097771/3578968
17097777. 351676567097797/357896817097793. 351676567097805/357896817097801. 351676567097821/357896817097827. 351676567097839/3578
96817097835. 351676567097862/357896817097868. 351676567097870/357896817097876. 351676567097888/357896817097884. 351676567097896/3
57896817097892. 351676567097912/357896817097918. 351676567097920/357896817097926. 351676567097938/357896817097934. 35167656709799
5/357896817097991. 351676567098019/357896817098015. 351676567098027/357896817098023. 351676567098712/357896817098718. 35167656709
8787/357896817098783. 351676567098944/357896817098940. 351676567099751/357896817099757. 351676567099769/357896817099765. 35167656
7099793/357896817099799. 351676567099801/357896817099807. 351676567099819/357896817099815. 351676567099843/357896817099849.351676
567099850/357896817099856. 351676567099868/357896817099864. 351676567099876/357896817099872. 351676567099900/357896817099906. 351
676567099918/357896817099914. 351676567099926/357896817099922. 351676567099934/357896817099930. 351676567099942/357896817099948.
351676567100047/357896817100043. 351676567100104/357896817100100. 351676567100153/357896817100159. 351676567100161/35789681710016
7. 351676567100203/357896817100209. 351676567100211/357896817100217. 351676567100237/357896817100233. 351676567100245/35789681710
0241. 351676567100260/357896817100266.351676567100278/357896817100274. 351676567100286/357896817100282. 351676567100302/357896817
100308. 351676567095460/357896817095466. 351676567095478/357896817095474. 351676567095494/357896817095490. 351676567095536/357896
817095532. 351676567095544/357896817095540. 351676567095551/357896817095557. 351676567095593/357896817095599. 351676567095601/357
896817095607. 351676567095619/357896817095615. 351676567095627/357896817095623. 351676567095650/357896817095656. 351676567095668/
357896817095664. 351676567095700/357896817095706. 351676567095718/357896817095714. 351676567095726/357896817095722. 3516765670957
42/357896817095748. 351676567095759/357896817095755. 351676567095767/357896817095763. 351676567095791/357896817095797. 3516765670
96062/357896817096068. 351676567096104/357896817096100. 351676567096112/357896817096118. 351676567096146/357896817096142. 3516765
67096153/357896817096159. 351676567096179/357896817096175. 351676567096187/357896817096183. 351676567096203/357896817096209. 3516
76567096229/357896817096225. 351676567096237/357896817096233. 351676567096260/357896817096266. 351676567096278/357896817096274. 3
51676567096294/357896817096290. 351676567096302/357896817096308. 351676567096310/357896817096316. 351676567096344/357896817096340
. 351676567096351/357896817096357. 351676567096377/357896817096373. 351676567096385/357896817096381. 351676567096393/357896817096
399. 351676567096401/357896817096407. 351676567096419/357896817096415. 351676567096427/357896817096423. 351676567096443/357896817
096449. 351676567096476/357896817096472. 351676567096484/357896817096480. 351676567105343/357896817105349. 351676567105350/357896
817105356. 351676567105376/357896817105372. 351676567105392/357896817105398. 351676567105418/357896817105414.351676567105434/3578
96817105430. 351676567105442/357896817105448. 351676567105467/357896817105463. 351676567105491/357896817105497. 351676567105509/3
57896817105505. 351676567105517/357896817105513. 351676567105525/357896817105521. 351676567105533/357896817105539. 35167656710555
8/357896817105554. 351676567105566/357896817105562. 351676567105590/357896817105596. 351676567105616/357896817105612. 35167656710
5624/357896817105620. 351676567105640/357896817105646. 351676567105681/357896817105687. 351676567105699/357896817105695. 35167656
7105731/357896817105737.351676567105939/357896817105935. 351676567105962/357896817105968. 351676567106010/357896817106016. 351676
567106036/357896817106032. 351676567106044/357896817106040. 351676567106101/357896817106107. 351676567106127/357896817106123. 351
676567106184/357896817106180. 351676567106200/357896817106206. 351676567106226/357896817106222. 351676567106234/357896817106230.
351676567104189/357896817104185. 351676567104205/357896817104201. 351676567104213/357896817104219. 351676567104346/35789681710434
2. 351676567104395/357896817104391. 351676567104411/357896817104417. 351676567104429/357896817104425. 351676567104445/35789681710
4441. 351676567104650/357896817104656. 351676567104718/357896817104714. 351676567104726/357896817104722. 351676567104759/35789681
7104755. 351676567104791/357896817104797. 351676567104809/357896817104805. 351676567104817/357896817104813. 351676567104825/35789
6817104821. 351676567104833/357896817104839. 351676567104858/357896817104854. 351676567104890/357896817104896. 351676567104908/35
7896817104904. 351676567104916/357896817104912. 351676567104924/357896817104920. 351676567104932/357896817104938. 351676567104957
/357896817104953. 351676567104981/357896817104987. 351676567105004/357896817105000. 351676567105012/357896817105018. 351676567105
038/357896817105034. 351676567105053/357896817105059. 351676567105095/357896817105091. 351676567105103/357896817105109. 351676567
105111/357896817105117. 351676567105152/357896817105158. 351676567105160/357896817105166. 351676567105202/357896817105208. 351676
567105210/357896817105216. 351676567105236/357896817105232. 351676567105251/357896817105257. 351676567105269/357896817105265. 351
676567105277/357896817105273. 351676567105293/357896817105299. 351676567105301/357896817105307.351676567105319/357896817105315. 3
51676567105327/357896817105323. 351676567105335/357896817105331. 351676567096500/357896817096506. 351676567096534/357896817096530
. 351676567096542/357896817096548. 351676567096575/357896817096571. 351676567096591/357896817096597. 351676567096773/357896817096
779. 351676567096856/357896817096852. 351676567096906/357896817096902. 351676567096922/357896817096928. 351676567096948/357896817
096944. 351676567096963/357896817096969. 351676567096997/357896817096993. 351676567097003/357896817097009. 351676567097029/357896
817097025.351676567097094/357896817097090. 351676567097110/357896817097116. 351676567097144/357896817097140. 351676567097151/3578
96817097157. 351676567097185/357896817097181. 351676567097193/357896817097199. 351676567097201/357896817097207. 351676567097219/3
57896817097215. 351676567097227/357896817097223. 351676567097268/357896817097264. 351676567097292/357896817097298. 35167656709730
0/357896817097306. 351676567097318/357896817097314. 351676567097334/357896817097330. 351676567097367/357896817097363. 35167656709
7375/357896817097371. 351676567097383/357896817097389. 351676567097409/357896817097405. 351676567097433/357896817097439. 35167656
032024001649177-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001649177-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
7097458/357896817097454. 351676567097474/357896817097470. 351676567097482/357896817097488. 351676567097490/357896817097496. 35167
6567097524/357896817097520. 351676567097532/357896817097538. 351676567097540/357896817097546. 351676567097565/357896817097561. 35
1676567097573/357896817097579. 351676567097607/357896817097603. 351676567097615/357896817097611XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001649177-3
Espacio para uso exclusivo de la Entidad Recaudadora
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