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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
032024001610008-8
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. HKG0402745
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
6900316255
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: 538117-DECL: 1857974-DO: 893127563241- 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: 3077135763. ID DELIVERY:
6079008189. 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
032024001610008
133. Feha: 202411 18
134 . Levante No. 032024001509988 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 92032408601944
Fecha presentación 2024-11-18 16:30:09
Valor pagado $0.00
Fecha de Impresión: 2024-11-18 16:30:16
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001610008-8
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: 351641241198346/351847821198347. 351641241198973/35184
7821198974. 351641241199328/351847821199329. 351641241199526/351847821199527. 351641241199682/351847821199683. 351641241199716/35
1847821199717. 351641241199724/351847821199725. 351641241199732/351847821199733. 351641241199757/351847821199758. 351641241199815
/351847821199816. 351641241199823/351847821199824. 351641241199849/351847821199840. 351641241199856/351847821199857.3516412411998
72/351847821199873. 351641241199898/351847821199899. 351641241199906/351847821199907. 351641241199930/351847821199931. 3516412411
99948/351847821199949. 351641241199955/351847821199956. 351641241199989/351847821199980. 351641241199997/351847821199998. 3516412
41200225/351847821200226. 351641241200274/351847821200275. 351641241200522/351847821200523. 351641241200597/351847821200598. 3516
41241200605/351847821200606. 351641241200860/351847821200861. 351641241200894/351847821200 895. 351641241200944/351847821200945.
351641241200969/351847821200960.351641241201041/351847821201042. 351641241201579/351847821201570. 351641241201777/351847821201778
. 351641241201959/351847821201950. 351641241202049/351847821202040. 351641241203385/351847821203386. 351641241203534/351847821203
535. 351641241203567/351847821203568. 351641241204177/351847821204178. 351641241204318/351847821204319. 351641241204326/351847821
204327. 351641241204359/351847821204350. 351641241204383/351847821204384. 351641241204417/351847821204418. 351641241204458/351847
821204459. 351641241204474/351847821204475. 351641241204557/351847821204558. 351641241204581/351847821204582. 351641241204979/351
847821204970. 351641241205026/351847821205027. 351641241205083/351847821205084. 351641241205091/351847821205092. 351641241205216/
351847821205217. 351641241205224/351847821205225. 351641241205257/351847821205258. 351641241206206/351847821206207. 3516412412070
55/351847821207056. 351641241207311/351847821207312. 351641241207576/351847821207577. 351641241207709/351847821207700. 3516412412
07717/351847821207718. 351641241207782/351847821207783. 351641241208111/351847821208112. 351641241208251/351847821208252. 3516412
41208327/351847821208328. 351641241208350/351847821208351. 351641241208541/351847821208542. 351641241208707/351847821208708. 3516
41241208715/351847821208716. 351641241208749/351847821208740. 351641241208756/351847821208757. 351641241208764/351847821208765. 3
51641241208772/351847821208773. 351641241208780/351847821208781. 351641241208814/351847821208815. 351641241208830/351847821208831
. 351641241208848/351847821208849. 351641241208863/351847821208864. 351641241208871/351847821208872. 351641241208889/351847821208
880. 351641241208897/351847821208898. 351641241208913/351847821208914. 351641241208939/351847821208930.351641241208947/3518478212
08948. 351641241208962/351847821208963. 351641241209051/351847821209052. 351641241209069/351847821209060. 351641241209085/3518478
21209086. 351641241209093/351847821209094. 351641241209101/351847821209102. 351641241209184/351847821209185. 351641241209226/3518
47821209227. 351641241209358/351847821209359. 351641241209390/351847821209391. 351641241209408/351847821209409. 351641241209424/3
51847821209425. 351641241209432/351847821209433. 351641241209440/351847821209441. 351641241209457/351847821209458. 35164124120946
5/351847821209466.351641241209481/351847821209482. 351641241209499/351847821209490. 351641241209507/351847821209508. 351641241209
515/351847821209516. 351641241209531/351847821209532. 351641241209549/351847821209540. 351641241209564/351847821209565. 351641241
209572/351847821209573. 351641241209580/351847821209581. 351641241209598/351847821209599. 351641241209606/351847821209607. 351641
241209630/351847821209631. 351641241209648/351847821209649. 351641241209655/351847821209656. 351641241209689/351847821209680. 351
641241209705/351847821209706. 351641241209721/351847821209722. 351641241209747/351847821209748. 351641241209754/351847821209755.
351641241209770/351847821209771. 351641241209788/351847821209789. 351641241209796/351847821209797. 351641241209952/35184782120995
3. 351641241210026/351847821210027. 351641241210042/351847821210043. 351641241210083/351847821210084. 351641241210091/35184782121
0092. 351641241210109/351847821210100. 351641241210166/351847821210167. 351641241210190/351847821210191. 351641241210224/35184782
1210225. 351641241210257/351847821210258. 351641241210265/351847821210266. 351641241210273/351847821210274. 351641241210281/35184
7821210282. 351641241210299/351847821210290. 351641241210307/351847821210308. 351641241210315/351847821210316. 351641241210331/35
1847821210332. 351641241210349/351847821210340. 351641241210372/351847821210373. 351641241210406/351847821210407. 351641241210414
/351847821210415. 351641241210422/351847821210423. 351641241210430/351847821210431. 351641241210448/351847821210449. 351641241210
455/351847821210456. 351641241210463/351847821210464. 351641241210489/351847821210480. 351641241210505/351847821210506. 351641241
210513/351847821210514. 351641241210547/351847821210548. 351641241210554/351847821210555.351641241210570/351847821210571. 3516412
41210612/351847821210613. 351641241210620/351847821210621. 351641241210653/351847821210654. 351641241210661/351847821210662. 3516
41241210679/351847821210670. 351641241210687/351847821210688. 351641241210695/351847821210696. 351641241210703/351847821210704. 3
51641241210711/351847821210712. 351641241210729/351847821210720. 351641241210737/351847821210738. 351641241210745/351847821210746
. 351641241210760/351847821210761. 351641241210778/351847821210779. 351641241210786/351847821210787. 351641241210794/351847821210
795.351641241210802/351847821210803. 351641241210810/351847821210811. 351641241210828/351847821210829. 351641241210836/3518478212
10837. 351641241210844/351847821210845. 351641241210851/351847821210852. 351641241210869/351847821210860. 351641241210877/3518478
21210878. 351641241210885/351847821210886. 351641241210893/351847821210894. 351641241210901/351847821210902. 351641241210919/3518
47821210910. 351641241210935/351847821210936. 351641241210943/351847821210944. 351641241210950/351847821210951. 351641241210976/3
51847821210977. 351641241210984/351847821210985. 351641241210992/351847821210993. 351641241211008/351847821211009. 35164124121103
2/351847821211033. 351641241211057/351847821211058. 351641241211065/351847821211066. 351641241211073/351847821211074. 35164124121
1099/351847821211090. 351641241211115/351847821211116. 351641241211123/351847821211124. 351641241211149/351847821211140. 35164124
1211156/351847821211157. 351641241211214/351847821211215. 351641241211222/351847821211223. 351641241211255/351847821211256. 35164
1241211263/351847821211264. 351641241211289/351847821211280. 351641241211305/351847821211306. 351641241211313/351847821211314. 35
1641241211339/351847821211330. 351641241211347/351847821211348. 351641241211354/351847821211355. 351641241211362/351847821211363.
351641241211370/351847821211371. 351641241211388/351847821211389. 351641241211396/351847821211397. 351641241211404/3518478212114
05. 351641241211412/351847821211413. 351641241211420/351847821211421. 351641241211438/351847821211439. 351641241211446/3518478212
11447. 351641241211453/351847821211454. 351641241211461/351847821211462. 351641241211511/351847821211512. 351641241211545/3518478
21211546. 351641241211560/351847821211561. 351641241211578/351847821211579.351641241211586/351847821211587. 351641241211602/35184
7821211603. 351641241211610/351847821211611. 351641241211628/351847821211629. 351641241211636/351847821211637. 351641241211651/35
1847821211652. 351641241211669/351847821211660. 351641241211693/351847821211694. 351641241211701/351847821211702. 351641241211727
/351847821211728. 351641241211750/351847821211751. 351641241211768/351847821211769. 351641241211776/351847821211777. 351641241211
784/351847821211785. 351641241211792/351847821211793. 351641241211818/351847821211819. 351641241211826/351847821211827.3516412412
11834/351847821211835. 351641241211842/351847821211843. 351641241211859/351847821211850. 351641241211867/351847821211868. 3516412
41211875/351847821211876. 351641241211891/351847821211892. 351641241211909/351847821211900. 351641241211917/351847821211918. 3516
41241211925/351847821211926. 351641241211933/351847821211934. 351641241211958/351847821211959. 351641241211966/351847821211967. 3
51641241211974/351847821211975. 351641241212014/351847821212015. 351641241212022/351847821212023. 351641241212089/351847821212080
. 351641241212105/351847821212106. 351641241212113/351847821212114. 351641241212139/351847821212130. 351641241212154/351847821212
155. 351641241212162/351847821212163. 351641241212196/351847821212197. 351641241212204/351847821212205. 351641241212212/351847821
212213. 351641241212220/351847821212221. 351641241212238/351847821212239. 351641241212295/351847821212296. 351641241212303/351847
821212304. 351641241212436/351847821212437. 351641241212451/351847821212452. 351641241212543/351847821212544. 351641241212626/351
847821212627. 351641241212642/351847821212643. 351641241212659/351847821212650. 351641241212683/351847821212684. 351641241212832/
351847821212833. 351641241212857/351847821212858. 351641241212899/351847821212890. 351641241212907/351847821212908. 3516412412129
15/351847821212916. 351641241212923/351847821212924. 351641241212931/351847821212932. 351641241213111/351847821213112. 3516412412
13129/351847821213120. 351641241213137/351847821213138. 351641241213178/351847821213179. 351641241213194/351847821213195. 3516412
41213202/351847821213203. 351641241213210/351847821213211. 351641241213228/351847821213229. 351641241213236/351847821213237. 3516
032024001610008-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001610008-8
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
41241213269/351847821213260. 351641241213277/351847821213278.351641241213467/351847821213468. 351641241213616/351847821213617. 35
1641241213889/351847821213880. 351641241213897/351847821213898. 351641241213905/351847821213906. 351641241213913/351847821213914.
351641241213962/351847821213963XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001610008-8
Espacio para uso exclusivo de la Entidad Recaudadora
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