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REPÚBLICA DE COLOMBIA
Declaración de Importación Privada 500
1. Año 2025
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032025000023970-8
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. 116575015145075
43 . Año – Mes – Día
2025 – 01 – 07
44 . Documento de transporte
No. T61725Q0060
45 . Año – Mes – Día
2024 – 12 – 30
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
6900329091
52 . Año – Mes – Día
2024 – 12 – 26
53 . Cod. país
procedencia
215
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.
4.410.50
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.
109.00
72 . Peso neto kgs. dcms.
79.20
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
20.669.45
79 . Valor fletes USD
930.86 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
95.272.798
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
95.272.798
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
1.05
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
931.91
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
21.601.36
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: 543103-DECL: 1873326-DO: 893100105251- 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
RESOLUCIÓN 5050 DEL 10 DE NOVIEMBRE DE 2016. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOM
OLOGACIÓN) // NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION.SAMSUNG ELECTRONICS COLOMB
IA S.A. OEA COD. OE0001. . PEDIDOS: 3080697803. ID DELIVERY: 6079750582. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A057MZSHLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05s DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, 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
032025000023970
133. Feha: 202501 08
134 . Levante No. 032025000021542 135 . Fecha
2025 – 01 – 08
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 92032500145651
Fecha presentación 2025-01-08 12:39:45
Valor pagado $0.00
Fecha de Impresión: 2025-01-08 12:39:50
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000023970-8
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A057M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A057M/DS,SILVER,LTC( QTY. 300,00 u )(300,00 PCE
); IMEIS: 350290619439782/355253229439787. 350290619439808/355253229439803. 350290619439816/355253229439811. 350290619439832/3552
53229439837. 350290619440574/355253229440579. 350290619440665/355253229440660. 350290619441044/355253229441049. 350290619441226/3
55253229441221. 350290619441234/355253229441239.350290619441317/355253229441312. 350290619441325/355253229441320. 350290619441440
/355253229441445. 350290619441457/355253229441452. 350290619441499/355253229441494. 350290619441572/355253229441577. 350290619441
598/355253229441593. 350290619441614/355253229441619. 350290619441630/355253229441635. 350290619441648/355253229441643. 350290619
441663/355253229441668. 350290619441671/355253229441676. 350290619441689/355253229441684. 350290619441697/355253229441692. 350290
619441705/355253229441700. 350290619441713/355253229441718. 350290619441739/355253229441734. 350290619441747/355253229441742. 350
290619441762/355253229441767. 350290619441770/355253229441775. 350290619441788/355253229441783. 350290619441796/355253229441791.
350290619441804/355253229441809. 350290619441812/355253229441817. 350290619441820/355253229441825. 350290619441838/35525322944183
3. 350290619441846/355253229441841. 350290619441853/355253229441858. 350290619441861/355253229441866. 350290619441879/35525322944
1874. 350290619441887/355253229441882. 350290619441895/355253229441890. 350290619441903/355253229441908. 350290619441929/35525322
9441924. 350290619441945/355253229441940. 350290619441952/355253229441957. 350290619441978/355253229441973. 350290619441994/35525
3229441999. 350290619442000/355253229442005. 350290619442018/355253229442013. 350290619442042/355253229442047. 350290619442059/35
5253229442054. 350290619442067/355253229442062. 350290619442075/355253229442070. 350290619442091/355253229442096. 350290619442109
/355253229442104. 350290619442117/355253229442112. 350290619442125/355253229442120. 350290619442133/355253229442138. 350290619442
158/355253229442153. 350290619442166/355253229442161. 350290619442174/355253229442179. 350290619442182/355253229442187. 350290619
442190/355253229442195. 350290619442208/355253229442203. 350290619442216/355253229442211. 350290619442224/355253229442229. 350290
619442232/355253229442237. 350290619442240/355253229442245. 350290619442257/355253229442252. 350290619442265/355253229442260. 350
290619442273/355253229442278. 350290619442281/355253229442286. 350290619442299/355253229442294. 350290619442307/355253229442302.
350290619442315/355253229442310. 350290619442323/355253229442328. 350290619442331/355253229442336. 350290619442356/35525322944235
1. 350290619442364/355253229442369.350290619442372/355253229442377. 350290619442380/355253229442385. 350290619442398/355253229442
393. 350290619442406/355253229442401. 350290619442414/355253229442419. 350290619442422/355253229442427. 350290619442430/355253229
442435. 350290619442463/355253229442468. 350290619442471/355253229442476. 350290619442489/355253229442484. 350290619442497/355253
229442492. 350290619442521/355253229442526. 350290619442539/355253229442534. 350290619442547/355253229442542. 350290619442570/355
253229442575. 350290619442588/355253229442583. 350290619442646/355253229442641.350290619442661/355253229442666. 350290619442695/3
55253229442690. 350290619442711/355253229442716. 350290619442745/355253229442740. 350290619442760/355253229442765. 35029061944277
8/355253229442773. 350290619442786/355253229442781. 350290619442794/355253229442799. 350290619442810/355253229442815. 35029061944
2836/355253229442831. 350290619442885/355253229442880. 350290619442893/355253229442898. 350290619442919/355253229442914. 35029061
9442927/355253229442922. 350290619442935/355253229442930. 350290619442943/355253229442948. 350290619442950/355253229442955. 35029
0619442968/355253229442963. 350290619442976/355253229442971. 350290619442984/355253229442989. 350290619442992/355253229442997. 35
0290619443008/355253229443003. 350290619443016/355253229443011. 350290619443024/355253229443029. 350290619443032/355253229443037.
350290619443040/355253229443045. 350290619439089/355253229439084. 350290619439105/355253229439100. 350290619439121/3552532294391
26. 350290619439154/355253229439159. 350290619439162/355253229439167. 350290619439188/355253229439183. 350290619439204/3552532294
39209. 350290619439212/355253229439217. 350290619439246/355253229439241. 350290619439253/355253229439258. 350290619439287/3552532
29439282. 350290619439303/355253229439308. 350290619439311/355253229439316. 350290619439329/355253229439324. 350290619439345/3552
53229439340. 350290619439352/355253229439357. 350290619439378/355253229439373. 350290619439386/355253229439381. 350290619439394/3
55253229439399. 350290619439428/355253229439423. 350290619439436/355253229439431. 350290619439444/355253229439449. 35029061943945
1/355253229439456. 350290619439469/355253229439464. 350290619439477/355253229439472. 350290619439493/355253229439498. 35029061943
9519/355253229439514.350290619439527/355253229439522. 350290619439535/355253229439530. 350290619439543/355253229439548. 350290619
439550/355253229439555. 350290619439568/355253229439563. 350290619439576/355253229439571. 350290619439584/355253229439589. 350290
619439600/355253229439605. 350290619439618/355253229439613. 350290619439626/355253229439621. 350290619439642/355253229439647. 350
290619439659/355253229439654. 350290619439683/355253229439688. 350290619439691/355253229439696. 350290619439709/355253229439704.
350290619439717/355253229439712. 350290619439725/355253229439720.350290619439733/355253229439738. 350290619434650/355253229434655
. 350290619434668/355253229434663. 350290619434692/355253229434697. 350290619434718/355253229434713. 350290619434726/355253229434
721. 350290619434734/355253229434739. 350290619434742/355253229434747. 350290619434783/355253229434788. 350290619434791/355253229
434796. 350290619434809/355253229434804. 350290619434825/355253229434820. 350290619434833/355253229434838. 350290619434858/355253
229434853. 350290619434866/355253229434861. 350290619435004/355253229435009. 350290619435012/355253229435017. 350290619435293/355
253229435298. 350290619435319/355253229435314. 350290619435327/355253229435322. 350290619435335/355253229435330. 350290619435343/
355253229435348. 350290619435350/355253229435355. 350290619435368/355253229435363. 350290619435376/355253229435371. 3502906194353
84/355253229435389. 350290619435400/355253229435405. 350290619435442/355253229435447. 350290619435483/355253229435488. 3502906194
35509/355253229435504. 350290619435525/355253229435520. 350290619435533/355253229435538. 350290619435558/355253229435553. 3502906
19435566/355253229435561. 350290619435590/355253229435595. 350290619435608/355253229435603. 350290619435624/355253229435629. 3502
90619435640/355253229435645. 350290619435665/355253229435660. 350290619435673/355253229435678. 350290619435681/355253229435686. 3
50290619435699/355253229435694. 350290619435715/355253229435710. 350290619435723/355253229435728. 350290619435731/355253229435736
. 350290619435749/355253229435744. 350290619435764/355253229435769. 350290619435772/355253229435777. 350290619435780/355253229435
785. 350290619435798/355253229435793. 350290619435806/355253229435801. 350290619435814/355253229435819. 350290619435822/355253229
435827.350290619435830/355253229435835. 350290619435848/355253229435843. 350290619435855/355253229435850. 350290619435889/3552532
29435884. 350290619435897/355253229435892. 350290619435905/355253229435900. 350290619435913/355253229435918. 350290619435921/3552
53229435926. 350290619435939/355253229435934. 350290619435947/355253229435942. 350290619435954/355253229435959. 350290619435988/3
55253229435983. 350290619436002/355253229436007. 350290619436010/355253229436015. 350290619436028/355253229436023. 35029061943606
9/355253229436064. 350290619436101/355253229436106.350290619436127/355253229436122. 350290619436176/355253229436171. 350290619436
259/355253229436254. 350290619436283/355253229436288. 350290619436333/355253229436338. 350290619436358/355253229436353. 350290619
436440/355253229436445. 350290619436507/355253229436502. 350290619436515/355253229436510. 350290619436549/355253229436544. 350290
619436655/355253229436650. 350290619436663/355253229436668. 350290619436739/355253229436734. 350290619436820/355253229436825. 350
290619436895/355253229436890. 350290619436937/355253229436932. 350290619436945/355253229436940. 350290619436986/355253229436981.
350290619437034/355253229437039. 350290619437059/355253229437054. 350290619437091/355253229437096. 350290619437109/35525322943710
4. 350290619437117/355253229437112. 350290619437208/355253229437203. 350290619437364/355253229437369. 350290619437406/35525322943
7401. 350290619437497/355253229437492. 350290619437547/355253229437542. 350290619437554/355253229437559. 350290619437562/35525322
9437567. 350290619437604/355253229437609. 350290619437620/355253229437625. 350290619437638/355253229437633. 350290619437646/35525
3229437641. 350290619437653/355253229437658. 350290619437679/355253229437674. 350290619437703/355253229437708. 350290619437729/35
5253229437724. 350290619437802/355253229437807. 350290619437810/355253229437815. 350290619437836/355253229437831. 350290619437919
/355253229437914. 350290619437927/355253229437922. 350290619437992/355253229437997. 350290619438032/355253229438037. 350290619438
081/355253229438086. 350290619438099/355253229438094. 350290619438107/355253229438102. 350290619438131/355253229438136. 350290619
438149/355253229438144. 350290619438164/355253229438169. 350290619438214/355253229438219. 350290619438453/355253229438458.3502906
032025000023970-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000023970-8
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
19438792/355253229438797. 350290619438859/355253229438854. 350290619438883/355253229438888. 350290619438958/355253229438953. 3502
90619438966/355253229438961. 350290619438990/355253229438995. 350290619439022/355253229439027. 350290619439030/355253229439035. 3
50290619439055/355253229439050. 350290619439063/355253229439068. 350290619439071/355253229439076XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025000023970-8
Espacio para uso exclusivo de la Entidad Recaudadora
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