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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
032024001610341-6
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. HKG0402473
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
6900315689
52 . Año – Mes – Día
2024 – 11 – 05
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
12.289.45
79 . Valor fletes USD
879.20 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
879.84
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: 538079-DECL: 1857925-DO: 893127556241- 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: 3077135773. ID DELIVERY: 6079008876. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MLGDLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOSPARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE CLARO,(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
032024001610341
133. Feha: 202411 18
134 . Levante No. 032024001510379 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 92032408603981
Fecha presentación 2024-11-18 16:51:47
Valor pagado $0.00
Fecha de Impresión: 2024-11-18 16:51:52
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001610341-6
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MODELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,LIGHT GREEN,LTC( QTY. 300,00 u )(300,
00 PCE); IMEIS: 351641241332945/351847821332946. 351641241333026/351847821333027. 351641241333034/351847821333035. 35164124133306
7/351847821333068. 351641241333083/351847821333084. 351641241333091/351847821333092. 351641241333166/351847821333167. 35164124133
3901/351847821333902. 351641241337381/351847821337382. 351641241337571/351847821337572. 351641241338009/351847821338000. 35164124
1338264/351847821338265. 351641241338397/351847821338398. 351641241338462/351847821338463. 351641241338496/351847821338497. 35164
1241338512/351847821338513. 351641241338587/351847821338588. 351641241338637/351847821338638. 351641241338694/351847821338695. 35
1641241338918/351847821338919. 351641241339007/351847821339008. 351641241339080/351847821339081. 351641241339122/351847821339123.
351641241339197/351847821339198. 351641241339213/351847821339214. 351641241339221/351847821 339222. 351641241339239/351847821339
230. 351641241339270/351847821339271. 351641241339304/351847821339305. 351641241339346/351847821339347.351641241339361/3518478213
39362. 351641241339379/351847821339370. 351641241339403/351847821339404. 351641241339478/351847821339479. 351641241339643/3518478
21339644. 351641241339742/351847821339743. 351641241339825/351847821339826. 351641241339858/351847821339859. 351641241339932/3518
47821339933. 351641241339957/351847821339958. 351641241340187/351847821340188. 351641241340195/351847821340196. 351641241340203/3
51847821340204. 351641241340237/351847821340238. 351641241340278/351847821340279. 351641241340294/351847821340295. 35164124134032
8/351847821340329.351641241340336/351847821340337. 351641241340344/351847821340345. 351641241340351/351847821340352. 351641241340
377/351847821340378. 351641241340385/351847821340386. 351641241340401/351847821340402. 351641241340419/351847821340410. 351641241
340427/351847821340428. 351641241340450/351847821340451. 351641241340468/351847821340469. 351641241340476/351847821340477. 351641
241340484/351847821340485. 351641241340500/351847821340501. 351641241340534/351847821340535. 351641241340591/351847821340592. 351
641241340625/351847821340626. 351641241340641/351847821340642. 351641241340666/351847821340667. 351641241340682/351847821340683.
351641241340732/351847821340733. 351641241340740/351847821340741. 351641241340799/351847821340790. 351641241340807/35184782134080
8. 351641241340815/351847821340816. 351641241340823/351847821340824. 351641241340856/351847821340857. 351641241340864/35184782134
0865. 351641241340880/351847821340881. 351641241340898/351847821340899. 351641241340906/351847821340907. 351641241340922/35184782
1340923. 351641241340948/351847821340949. 351641241340955/351847821340956. 351641241340971/351847821340972. 351641241340989/35184
7821340980. 351641241341003/351847821341004. 351641241341011/351847821341012. 351641241341037/351847821341038. 351641241341045/35
1847821341046. 351641241341052/351847821341053. 351641241341078/351847821341079. 351641241341086/351847821341087. 351641241341102
/351847821341103. 351641241341144/351847821341145. 351641241341151/351847821341152. 351641241341169/351847821341160. 351641241341
235/351847821341236. 351641241341284/351847821341285. 351641241341326/351847821341327. 351641241341334/351847821341335. 351641241
341342/351847821341343. 351641241341367/351847821341368. 351641241341391/351847821341392.351641241341409/351847821341400. 3516412
41341417/351847821341418. 351641241341433/351847821341434. 351641241341466/351847821341467. 351641241341474/351847821341475. 3516
41241341508/351847821341509. 351641241341516/351847821341517. 351641241341540/351847821341541. 351641241341557/351847821341558. 3
51641241341573/351847821341574. 351641241341581/351847821341582. 351641241341623/351847821341624. 351641241341631/351847821341632
. 351641241341664/351847821341665. 351641241341680/351847821341681. 351641241341698/351847821341699. 351641241341730/351847821341
731.351641241341763/351847821341764. 351641241341797/351847821341798. 351641241341813/351847821341814. 351641241341821/3518478213
41822. 351641241341896/351847821341897. 351641241341946/351847821341947. 351641241342035/351847821342036. 351641241342092/3518478
21342093. 351641241342217/351847821342218. 351641241342241/351847821342242. 351641241342274/351847821342275. 351641241342316/3518
47821342317. 351641241342324/351847821342325. 351641241342340/351847821342341. 351641241342373/351847821342374. 351641241342399/3
51847821342390. 351641241342423/351847821342424. 351641241342431/351847821342432. 351641241343751/351847821343752. 35164124134376
9/351847821343760. 351641241343777/351847821343778. 351641241343785/351847821343786. 351641241343892/351847821343893. 35164124134
3900/351847821343901. 351641241343942/351847821343943. 351641241343959/351847821343950. 351641241343967/351847821343968. 35164124
1343975/351847821343976. 351641241343983/351847821343984. 351641241343991/351847821343992. 351641241344015/351847821344016. 35164
1241344031/351847821344032. 351641241344064/351847821344065. 351641241344106/351847821344107. 351641241344114/351847821344115. 35
1641241344130/351847821344131. 351641241344148/351847821344149. 351641241344239/351847821344230. 351641241344254/351847821344255.
351641241344262/351847821344263. 351641241344270/351847821344271. 351641241344304/351847821344305. 351641241344320/3518478213443
21. 351641241344338/351847821344339. 351641241344379/351847821344370. 351641241344395/351847821344396. 351641241344411/3518478213
44412. 351641241344445/351847821344446. 351641241344452/351847821344453. 351641241344460/351847821344461. 351641241344502/3518478
21344503. 351641241344536/351847821344537. 351641241344544/351847821344545.351641241344569/351847821344560. 351641241344585/35184
7821344586. 351641241344593/351847821344594. 351641241344601/351847821344602. 351641241344619/351847821344610. 351641241344627/35
1847821344628. 351641241344643/351847821344644. 351641241344650/351847821344651. 351641241344668/351847821344669. 351641241344676
/351847821344677. 351641241344692/351847821344693. 351641241344700/351847821344701. 351641241344726/351847821344727. 351641241344
734/351847821344735. 351641241344767/351847821344768. 351641241344783/351847821344784. 351641241344791/351847821344792.3516412413
44809/351847821344800. 351641241344817/351847821344818. 351641241344825/351847821344826. 351641241344841/351847821344842. 3516412
41344858/351847821344859. 351641241344866/351847821344867. 351641241344882/351847821344883. 351641241344890/351847821344891. 3516
41241344908/351847821344909. 351641241344916/351847821344917. 351641241344932/351847821344933. 351641241344940/351847821344941. 3
51641241344965/351847821344966. 351641241345004/351847821345005. 351641241345012/351847821345013. 351641241345038/351847821345039
. 351641241345046/351847821345047. 351641241345061/351847821345062. 351641241345129/351847821345120. 351641241345194/351847821345
195. 351641241345210/351847821345211. 351641241345244/351847821345245. 351641241345251/351847821345252. 351641241345277/351847821
345278. 351641241345301/351847821345302. 351641241345343/351847821345344. 351641241345350/351847821345351. 351641241345376/351847
821345377. 351641241345384/351847821345385. 351641241345392/351847821345393. 351641241345400/351847821345401. 351641241345426/351
847821345427. 351641241345442/351847821345443. 351641241345467/351847821345468. 351641241345509/351847821345500. 351641241345533/
351847821345534. 351641241345558/351847821345559. 351641241345574/351847821345575. 351641241345590/351847821345591. 3516412413456
16/351847821345617. 351641241345871/351847821345872. 351641241346614/351847821346615. 351641241346721/351847821346722. 3516412413
46754/351847821346755. 351641241346770/351847821346771. 351641241346788/351847821346789. 351641241346796/351847821346797. 3516412
41346804/351847821346805. 351641241346820/351847821346821. 351641241346838/351847821346839. 351641241346846/351847821346847. 3516
41241346853/351847821346854. 351641241346879/351847821346870.351641241346895/351847821346896. 351641241346903/351847821346904. 35
1641241346929/351847821346920. 351641241346945/351847821346946. 351641241346952/351847821346953. 351641241346986/351847821346987.
351641241346994/351847821346995. 351641241347018/351847821347019. 351641241347026/351847821347027. 351641241347042/3518478213470
43. 351641241347075/351847821347076. 351641241347083/351847821347084. 351641241347141/351847821347142. 351641241347158/3518478213
47159. 351641241347208/351847821347209. 351641241342514/351847821342515. 351641241342563/351847821342564.351641241342571/35184782
1342572. 351641241342647/351847821342648. 351641241342688/351847821342689. 351641241342696/351847821342697. 351641241342704/35184
7821342705. 351641241342720/351847821342721. 351641241342738/351847821342739. 351641241342829/351847821342820. 351641241342845/35
1847821342846. 351641241342886/351847821342887. 351641241342902/351847821342903. 351641241342910/351847821342911. 351641241342936
/351847821342937. 351641241342944/351847821342945. 351641241342951/351847821342952. 351641241342977/351847821342978. 351641241343
009/351847821343000. 351641241343033/351847821343034. 351641241343090/351847821343091. 351641241343157/351847821343158. 351641241
343165/351847821343166. 351641241343173/351847821343174. 351641241343199/351847821343190. 351641241343249/351847821343240. 351641
241343264/351847821343265. 351641241343348/351847821343349. 351641241343363/351847821343364. 351641241343371/351847821343372. 351
641241343447/351847821343448. 351641241343470/351847821343471. 351641241343488/351847821343489. 351641241343496/351847821343497.
032024001610341-6
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001610341-6
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
351641241343587/351847821343588. 351641241343595/351847821343596. 351641241343603/351847821343604. 351641241343611/35184782134361
2. 351641241343629/351847821343620. 351641241343660/351847821343661. 351641241343686/351847821343687. 351641241343694/35184782134
3695. 351641241343702/351847821343703. 351641241343710/351847821343711. 351641241343728/351847821343729XXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001610341-6
Espacio para uso exclusivo de la Entidad Recaudadora
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