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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
032024001610022-1
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. 116575014983847
43 . Año – Mes – Día
2024 – 11 – 16
44 . Documento de transporte
No. HKG0402744
45 . Año – Mes – Día
2024 – 11 – 12
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
6900318000
52 . Año – Mes – Día
2024 – 11 – 06
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
244
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.475.57
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
215
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.
111.00
72 . Peso neto kgs. dcms.
81.30
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
12.297.30
79 . Valor fletes USD
871.35 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
58.940.079
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
58.940.079
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
0.64
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
871.99
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
13.169.29
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: 538108-DECL: 1857962-DO: 893127562241- 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, MERCANC
IA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3077135758. ID DELIVERY:
6079008914. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZKDLTC, PRODUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA
USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, MODELO:SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y 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
032024001610022
133. Feha: 202411 18
134 . Levante No. 032024001510059 135 . Fecha
2024 – 11 – 18
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 92032408602215
Fecha presentación 2024-11-18 16:31:49
Valor pagado $0.00
Fecha de Impresión: 2024-11-18 16:34:06
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001610022-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DETAL/ /MOBILE,SM-A055M/DS,BLACK,LTC( QTY. 300,00 u )(300,00 PCE); IMEIS: 351641241198130/351847821198131. 351641241198262/35184
7821198263. 351641241198395/351847821198396. 351641241198478/351847821198479. 351641241198494/351847821198495. 351641241198551/35
1847821198552. 351641241198668/351847821198669. 351641241198700/351847821198701. 351641241200126/351847821200127. 351641241200514
/351847821200515. 351641241200555/351847821200556. 351641241201413/351847821201414. 351641241201686/351847821201687.3516412412019
00/351847821201901. 351641241202510/351847821202511. 351641241202650/351847821202651. 351641241202668/351847821202669. 3516412412
02700/351847821202701. 351641241202726/351847821202727. 351641241203013/351847821203014. 351641241204011/351847821204012. 3516412
41205208/351847821205209. 351641241205265/351847821205266. 351641241205455/351847821205456. 351641241205463/351847821205464. 3516
41241205927/351847821205928. 351641241206032/351847821206033. 351641241208160/351847821208 161. 351641241209135/351847821209136.
351641241209200/351847821209201.351641241209341/351847821209342. 351641241209366/351847821209367. 351641241211685/351847821211686
. 351641241211800/351847821211801. 351641241212121/351847821212122. 351641241212287/351847821212288. 351641241212329/351847821212
320. 351641241212337/351847821212338. 351641241212352/351847821212353. 351641241212402/351847821212403. 351641241212550/351847821
212551. 351641241213079/351847821213070. 351641241213293/351847821213294. 351641241213335/351847821213336. 351641241213350/351847
821213351. 351641241213368/351847821213369. 351641241213376/351847821213377. 351641241213434/351847821213435. 351641241213723/351
847821213724. 351641241213749/351847821213740. 351641241213756/351847821213757. 351641241213764/351847821213765. 351641241213780/
351847821213781. 351641241213806/351847821213807. 351641241213814/351847821213815. 351641241213830/351847821213831. 3516412412138
55/351847821213856. 351641241213863/351847821213864. 351641241213871/351847821213872. 351641241213921/351847821213922. 3516412412
13947/351847821213948. 351641241213954/351847821213955. 351641241214044/351847821214045. 351641241214085/351847821214086. 3516412
41214127/351847821214128. 351641241214242/351847821214243. 351641241214283/351847821214284. 351641241214317/351847821214318. 3516
41241214325/351847821214326. 351641241214358/351847821214359. 351641241214382/351847821214383. 351641241214424/351847821214425. 3
51641241214606/351847821214607. 351641241214614/351847821214615. 351641241214655/351847821214656. 351641241214671/351847821214672
. 351641241214689/351847821214680. 351641241214697/351847821214698. 351641241214713/351847821214714. 351641241214739/351847821214
730. 351641241214838/351847821214839. 351641241214937/351847821214938. 351641241214994/351847821214995.351641241215140/3518478212
15141. 351641241215207/351847821215208. 351641241215223/351847821215224. 351641241215298/351847821215299. 351641241215322/3518478
21215323. 351641241215330/351847821215331. 351641241215447/351847821215448. 351641241215595/351847821215596. 351641241215678/3518
47821215679. 351641241215694/351847821215695. 351641241215702/351847821215703. 351641241215728/351847821215729. 351641241215835/3
51847821215836. 351641241216049/351847821216040. 351641241216288/351847821216289. 351641241216296/351847821216297. 35164124121631
2/351847821216313.351641241216379/351847821216370. 351641241216395/351847821216396. 351641241216452/351847821216453. 351641241216
478/351847821216479. 351641241216684/351847821216685. 351641241216759/351847821216750. 351641241216791/351847821216792. 351641241
216809/351847821216800. 351641241216817/351847821216818. 351641241216825/351847821216826. 351641241216874/351847821216875. 351641
241216882/351847821216883. 351641241216908/351847821216909. 351641241216916/351847821216917. 351641241216924/351847821216925. 351
641241216965/351847821216966. 351641241216981/351847821216982. 351641241216999/351847821216990. 351641241217013/351847821217014.
351641241217039/351847821217030. 351641241217047/351847821217048. 351641241217054/351847821217055. 351641241217062/35184782121706
3. 351641241217088/351847821217089. 351641241217120/351847821217121. 351641241217138/351847821217139. 351641241217278/35184782121
7279. 351641241217518/351847821217519. 351641241218045/351847821218046. 351641241218243/351847821218244. 351641241218417/35184782
1218418. 351641241218490/351847821218491. 351641241218540/351847821218541. 351641241221163/351847821221164. 351641241221866/35184
7821221867. 351641241221874/351847821221875. 351641241221924/351847821221925. 351641241222146/351847821222147. 351641241222153/35
1847821222154. 351641241222245/351847821222246. 351641241222575/351847821222576. 351641241222989/351847821222980. 351641241223417
/351847821223418. 351641241223441/351847821223442. 351641241223458/351847821223459. 351641241223649/351847821223640. 351641241223
680/351847821223681. 351641241223706/351847821223707. 351641241223730/351847821223731. 351641241223961/351847821223962. 351641241
224050/351847821224051. 351641241224100/351847821224101. 351641241224142/351847821224143.351641241224191/351847821224192. 3516412
41224241/351847821224242. 351641241224266/351847821224267. 351641241224274/351847821224275. 351641241224308/351847821224309. 3516
41241224332/351847821224333. 351641241224415/351847821224416. 351641241224456/351847821224457. 351641241224464/351847821224465. 3
51641241224480/351847821224481. 351641241224498/351847821224499. 351641241224530/351847821224531. 351641241224548/351847821224549
. 351641241224563/351847821224564. 351641241224621/351847821224622. 351641241224662/351847821224663. 351641241224886/351847821224
887.351641241225214/351847821225215. 351641241225354/351847821225355. 351641241225388/351847821225389. 351641241225420/3518478212
25421. 351641241225453/351847821225454. 351641241225461/351847821225462. 351641241225966/351847821225967. 351641241226063/3518478
21226064. 351641241226071/351847821226072. 351641241226121/351847821226122. 351641241226196/351847821226197. 351641241226204/3518
47821226205. 351641241226246/351847821226247. 351641241226261/351847821226262. 351641241226329/351847821226320. 351641241226378/3
51847821226379. 351641241226386/351847821226387. 351641241226402/351847821226403. 351641241226410/351847821226411. 35164124122643
6/351847821226437. 351641241226444/351847821226445. 351641241226477/351847821226478. 351641241226493/351847821226494. 35164124122
6501/351847821226502. 351641241226519/351847821226510. 351641241226535/351847821226536. 351641241226543/351847821226544. 35164124
1226568/351847821226569. 351641241226634/351847821226635. 351641241226725/351847821226726. 351641241226758/351847821226759. 35164
1241226774/351847821226775. 351641241226782/351847821226783. 351641241226808/351847821226809. 351641241226816/351847821226817. 35
1641241226865/351847821226866. 351641241226899/351847821226890. 351641241226915/351847821226916. 351641241226931/351847821226932.
351641241226949/351847821226940. 351641241226956/351847821226957. 351641241226964/351847821226965. 351641241226972/3518478212269
73. 351641241226998/351847821226999. 351641241227004/351847821227005. 351641241227012/351847821227013. 351641241227053/3518478212
27054. 351641241227079/351847821227070. 351641241227137/351847821227138. 351641241227152/351847821227153. 351641241227160/3518478
21227161. 351641241227244/351847821227245. 351641241227269/351847821227260.351641241229109/351847821229100. 351641241229281/35184
7821229282. 351641241229323/351847821229324. 351641241229364/351847821229365. 351641241229372/351847821229373. 351641241229380/35
1847821229381. 351641241229422/351847821229423. 351641241229448/351847821229449. 351641241229802/351847821229803. 351641241229810
/351847821229811. 351641241229836/351847821229837. 351641241229851/351847821229852. 351641241229869/351847821229860. 351641241229
877/351847821229878. 351641241229893/351847821229894. 351641241229935/351847821229936. 351641241229976/351847821229977.3516412412
30073/351847821230074. 351641241230149/351847821230140. 351641241230156/351847821230157. 351641241230172/351847821230173. 3516412
41230743/351847821230744. 351641241230768/351847821230769. 351641241230776/351847821230777. 351641241230792/351847821230793. 3516
41241230917/351847821230918. 351641241230925/351847821230926. 351641241230974/351847821230975. 351641241230982/351847821230983. 3
51641241231006/351847821231007. 351641241231154/351847821231155. 351641241231766/351847821231767. 351641241231774/351847821231775
. 351641241232038/351847821232039. 351641241232053/351847821232054. 351641241232129/351847821232120. 351641241232145/351847821232
146. 351641241232319/351847821232310. 351641241232384/351847821232385. 351641241232442/351847821232443. 351641241232467/351847821
232468. 351641241233028/351847821233029. 351641241233119/351847821233110. 351641241233150/351847821233151. 351641241233234/351847
821233235. 351641241233309/351847821233300. 351641241233333/351847821233334. 351641241233358/351847821233359. 351641241233408/351
847821233409. 351641241233473/351847821233474. 351641241233507/351847821233508. 351641241233580/351847821233581. 351641241233598/
351847821233599. 351641241233648/351847821233649. 351641241233655/351847821233656. 351641241233663/351847821233664. 3516412412337
21/351847821233722. 351641241233739/351847821233730. 351641241233747/351847821233748. 351641241233754/351847821233755. 3516412412
33820/351847821233821. 351641241233838/351847821233839. 351641241233853/351847821233854. 351641241233929/351847821233920. 3516412
41233994/351847821233995. 351641241234661/351847821234662. 351641241234711/351847821234712. 351641241234737/351847821234738. 3516
032024001610022-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001610022-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
41241234869/351847821234860. 351641241234893/351847821234894.351641241234935/351847821234936. 351641241235148/351847821235149. 35
1641241235684/351847821235685. 351641241236823/351847821236824. 351641241236971/351847821236972. 351641241237177/351847821237178.
351641241237318/351847821237319XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001610022-1
Espacio para uso exclusivo de la Entidad Recaudadora
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