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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
032024001824049-9
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
Anticipada
33 . Cod.
3
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. 116575015127461
43 . Año – Mes – Día
2024 – 12 – 29
44 . Documento de transporte
No. HKG0402655
45 . Año – Mes – Día
2024 – 12 – 24
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
6900326886
52 . Año – Mes – Día
2024 – 12 – 17
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.
4.394.50
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.
137.00
72 . Peso neto kgs. dcms.
105.60
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
400.00
78 .Valor FOB
USD
27.829.83
79 . Valor fletes USD
1.075.45 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
127.030.405
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
127.030.405
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
1.40
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.076.85
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
28.906.68
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: 542434-DECL: 1872044-DO: 893130782241- 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: 3079835588. ID DELIVERY: 6079677650. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A057MZKHLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05S 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
032024001824049
133. Feha: 202412 27
134 . Levante No. 032024001736795 135 . Fecha
2024 – 12 – 30
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 92032409683638
Fecha presentación 2024-12-27 20:30:11
Valor pagado $0.00
Fecha de Impresión: 2024-12-30 12:03:02
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001824049-9
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,BLACK,LTC( QTY. 400,00 u )(400,00 PCE);
IMEIS: 350290619168365/355253229168360. 350290619168373/355253229168378. 350290619168381/355253229168386. 350290619168399/355253
229168394. 350290619168761/355253229168766. 350290619169405/355253229169400. 350290619169488/355253229169483. 350290619169512/355
253229169517. 350290619169520/355253229169525. 350290619169561/355253229169566. 350290619169579/355253229169574. 350290619169587/
355253229169582. 350290619169595/355253229169590. 350290619169603/355253229169608. 350290619169637/355253229169632. 3502906191696
86/355253229169681. 350290619169728/355253229169723. 350290619169736/355253229169731. 350290619169744/355253229169749. 3502906191
69751/355253229169756. 350290619169769/355253229169764. 350290619169777/355253229169772. 350290619169793/355253229169798. 3502906
19169819/355253229169814. 350290619169835/355253229169830. 350290619169843/355253229169848. 3 50290619169868/355253229169863. 350
290619169884/355253229169889. 350290619169934/355253229169939. 350290619169942/355253229169947. 350290619169975/355253229169970.
350290619169983/355253229169988. 350290619170007/355253229170002. 350290619170213/355253229170218. 350290619170619/35525322917061
4. 350290619170643/355253229170648. 350290619170668/355253229170663. 350290619170684/355253229170689. 350290619170718/35525322917
0713. 350290619170734/355253229170739. 350290619170775/355253229170770. 350290619170833/355253229170838. 350290619170874/35525322
9170879.350290619170882/355253229170887. 350290619170924/355253229170929. 350290619170932/355253229170937. 350290619170940/355253
229170945. 350290619170965/355253229170960. 350290619171765/355253229171760. 350290619172094/355253229172099. 350290619172110/355
253229172115. 350290619172151/355253229172156. 350290619172169/355253229172164. 350290619172656/355253229172651. 350290619173209/
355253229173204. 350290619173324/355253229173329. 350290619173613/355253229173618. 350290619173688/355253229173683. 3502906191737
61/355253229173766. 350290619173811/355253229173816.350290619173829/355253229173824. 350290619173845/355253229173840. 35029061917
3886/355253229173881. 350290619173902/355253229173907. 350290619173993/355253229173998. 350290619174009/355253229174004. 35029061
9174041/355253229174046. 350290619174058/355253229174053. 350290619174066/355253229174061. 350290619174090/355253229174095. 35029
0619174199/355253229174194. 350290619174223/355253229174228. 350290619174249/355253229174244. 350290619174264/355253229174269. 35
0290619174272/355253229174277. 350290619174363/355253229174368. 350290619174678/355253229174673. 350290619175071/355253229175076.
350290619175477/355253229175472. 350290619175709/355253229175704. 350290619175816/355253229175811. 350290619176038/3552532291760
33. 350290619176483/355253229176488. 350290619176491/355253229176496. 350290619176509/355253229176504. 350290619176517/3552532291
76512. 350290619176525/355253229176520. 350290619176533/355253229176538. 350290619176541/355253229176546. 350290619176558/3552532
29176553. 350290619176566/355253229176561. 350290619176574/355253229176579. 350290619176582/355253229176587. 350290619176590/3552
53229176595. 350290619176608/355253229176603. 350290619176616/355253229176611. 350290619176624/355253229176629. 350290619176673/3
55253229176678. 350290619178125/355253229178120. 350290619178174/355253229178179. 350290619178216/355253229178211. 35029061917826
5/355253229178260. 350290619178315/355253229178310. 350290619178323/355253229178328. 350290619178331/355253229178336. 35029061917
8349/355253229178344. 350290619178356/355253229178351. 350290619178372/355253229178377. 350290619178422/355253229178427. 35029061
9178448/355253229178443. 350290619178463/355253229178468. 350290619178497/355253229178492. 350290619178505/355253229178500.350290
619178513/355253229178518. 350290619178521/355253229178526. 350290619178547/355253229178542. 350290619178562/355253229178567. 350
290619178570/355253229178575. 350290619178588/355253229178583. 350290619178596/355253229178591. 350290619178604/355253229178609.
350290619178612/355253229178617. 350290619178620/355253229178625. 350290619178638/355253229178633. 350290619178976/35525322917897
1. 350290619179412/355253229179417. 350290619180303/355253229180308. 350290619180311/355253229180316. 350290619180360/35525322918
0365. 350290619180451/355253229180456.350290619180493/355253229180498. 350290619180519/355253229180514. 350290619180535/355253229
180530. 350290619180584/355253229180589. 350290619180691/355253229180696. 350290619180733/355253229180738. 350290619181467/355253
229181462. 350290619181475/355253229181470. 350290619181590/355253229181595. 350290619181608/355253229181603. 350290619181632/355
253229181637. 350290619181657/355253229181652. 350290619181673/355253229181678. 350290619181715/355253229181710. 350290619181848/
355253229181843. 350290619181855/355253229181850. 350290619181871/355253229181876. 350290619182036/355253229182031. 3502906191820
51/355253229182056. 350290619182101/355253229182106. 350290619182473/355253229182478. 350290619183059/355253229183054. 3502906191
83141/355253229183146. 350290619183612/355253229183617. 350290619184826/355253229184821. 350290619184891/355253229184896. 3502906
19184917/355253229184912. 350290619184941/355253229184946. 350290619186763/355253229186768. 350290619186771/355253229186776. 3502
90619186797/355253229186792. 350290619186847/355253229186842. 350290619186896/355253229186891. 350290619186912/355253229186917. 3
50290619186946/355253229186941. 350290619186979/355253229186974. 350290619186995/355253229186990. 350290619187068/355253229187063
. 350290619187118/355253229187113. 350290619187142/355253229187147. 350290619187159/355253229187154. 350290619187175/355253229187
170. 350290619187183/355253229187188. 350290619187209/355253229187204. 350290619187217/355253229187212. 350290619187225/355253229
187220. 350290619187266/355253229187261. 350290619187274/355253229187279. 350290619187597/355253229187592. 350290619187621/355253
229187626. 350290619187639/355253229187634. 350290619187647/355253229187642. 350290619187654/355253229187659.350290619187761/3552
53229187766. 350290619187779/355253229187774. 350290619187795/355253229187790. 350290619187811/355253229187816. 350290619190112/3
55253229190117. 350290619190294/355253229190299. 350290619190856/355253229190851. 350290619191045/355253229191040. 35029061919132
6/355253229191321. 350290619191458/355253229191453. 350290619191649/355253229191644. 350290619192159/355253229192154. 35029061919
2548/355253229192543. 350290619192738/355253229192733. 350290619192761/355253229192766. 350290619194924/355253229194929. 35029061
9194957/355253229194952.350290619194973/355253229194978. 350290619195020/355253229195025. 350290619195038/355253229195033. 350290
619195046/355253229195041. 350290619195053/355253229195058. 350290619195079/355253229195074. 350290619195087/355253229195082. 350
290619195095/355253229195090. 350290619195103/355253229195108. 350290619195111/355253229195116. 350290619195129/355253229195124.
350290619195137/355253229195132. 350290619195145/355253229195140. 350290619195152/355253229195157. 350290619195160/35525322919516
5. 350290619195178/355253229195173. 350290619195194/355253229195199. 350290619195202/355253229195207. 350290619195210/35525322919
5215. 350290619195228/355253229195223. 350290619145140/355253229145145. 350290619145157/355253229145152. 350290619145223/35525322
9145228. 350290619145512/355253229145517. 350290619146437/355253229146432. 350290619147047/355253229147042. 350290619147302/35525
3229147307. 350290619147948/355253229147943. 350290619148128/355253229148123. 350290619148136/355253229148131. 350290619148177/35
5253229148172. 350290619148441/355253229148446. 350290619148565/355253229148560. 350290619148672/355253229148677. 350290619148839
/355253229148834. 350290619148847/355253229148842. 350290619149183/355253229149188. 350290619149357/355253229149352. 350290619149
373/355253229149378. 350290619149415/355253229149410. 350290619149456/355253229149451. 350290619150223/355253229150228. 350290619
150256/355253229150251. 350290619150314/355253229150319. 350290619151148/355253229151143. 350290619152203/355253229152208. 350290
619152229/355253229152224. 350290619152237/355253229152232. 350290619152252/355253229152257. 350290619152260/355253229152265. 350
290619152294/355253229152299. 350290619152302/355253229152307. 350290619152310/355253229152315.350290619152328/355253229152323. 3
50290619152336/355253229152331. 350290619152344/355253229152349. 350290619152351/355253229152356. 350290619152369/355253229152364
. 350290619152377/355253229152372. 350290619152401/355253229152406. 350290619152419/355253229152414. 350290619152427/355253229152
422. 350290619152435/355253229152430. 350290619152443/355253229152448. 350290619152492/355253229152497. 350290619152518/355253229
152513. 350290619152542/355253229152547. 350290619152567/355253229152562. 350290619152575/355253229152570. 350290619152583/355253
229152588.350290619152591/355253229152596. 350290619152617/355253229152612. 350290619152633/355253229152638. 350290619152658/3552
53229152653. 350290619152666/355253229152661. 350290619152690/355253229152695. 350290619152716/355253229152711. 350290619152732/3
55253229152737. 350290619152831/355253229152836. 350290619152880/355253229152885. 350290619152989/355253229152984. 35029061915300
3/355253229153008. 350290619153359/355253229153354. 350290619153805/355253229153800. 350290619154217/355253229154212. 35029061915
4316/355253229154311. 350290619155149/355253229155144. 350290619155560/355253229155565. 350290619156170/355253229156175. 35029061
032024001824049-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001824049-9
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
9156220/355253229156225. 350290619156253/355253229156258. 350290619156261/355253229156266. 350290619156287/355253229156282. 35029
0619156329/355253229156324. 350290619156352/355253229156357. 350290619156360/355253229156365. 350290619156378/355253229156373. 35
0290619156394/355253229156399. 350290619156402/355253229156407. 350290619156436/355253229156431. 350290619156451/355253229156456.
350290619156501/355253229156506. 350290619156592/355253229156597. 350290619157681/355253229157686. 350290619157913/3552532291579
18. 350290619158168/355253229158163. 350290619158457/355253229158452. 350290619158606/355253229158601. 350290619158770/3552532291
58775. 350290619159596/355253229159591. 350290619159745/355253229159740. 350290619159752/355253229159757. 350290619159893/3552532
29159898. 350290619159927/355253229159922. 350290619160636/355253229160631. 350290619160842/355253229160847. 350290619160883/3552
53229160888. 350290619160909/355253229160904. 350290619160933/355253229160938. 350290619160966/355253229160961. 350290619161022/3
55253229161027. 350290619161030/355253229161035. 350290619161055/355253229161050.350290619161121/355253229161126. 350290619161139
/355253229161134. 350290619161147/355253229161142. 350290619161154/355253229161159. 350290619161196/355253229161191. 350290619161
204/355253229161209. 350290619161220/355253229161225. 350290619161253/355253229161258. 350290619161279/355253229161274. 350290619
161303/355253229161308. 350290619161311/355253229161316. 350290619161337/355253229161332. 350290619161360/355253229161365. 350290
619161410/355253229161415. 350290619161477/355253229161472. 350290619161535/355253229161530. 350290619162137/355253229162132.3502
90619162145/355253229162140. 350290619162152/355253229162157. 350290619162178/355253229162173. 350290619162194/355253229162199. 3
50290619162202/355253229162207. 350290619162244/355253229162249. 350290619162251/355253229162256. 350290619162301/355253229162306
. 350290619162483/355253229162488. 350290619162582/355253229162587. 350290619162590/355253229162595. 350290619162657/355253229162
652. 350290619162780/355253229162785. 350290619162897/355253229162892. 350290619164620/355253229164625. 350290619164661/355253229
164666. 350290619164687/355253229164682. 350290619164703/355253229164708. 350290619164711/355253229164716. 350290619164729/355253
229164724. 350290619164737/355253229164732. 350290619164778/355253229164773. 350290619164786/355253229164781. 350290619164794/355
253229164799. 350290619164836/355253229164831. 350290619164844/355253229164849. 350290619164869/355253229164864. 350290619164943/
355253229164948. 350290619165114/355253229165119. 350290619165338/355253229165333. 350290619165437/355253229165432. 3502906191657
18/355253229165713. 350290619165759/355253229165754. 350290619165981/355253229165986. 350290619166161/355253229166166. 3502906191
66476/355253229166471. 350290619166484/355253229166489. 350290619166567/355253229166562. 350290619166724/355253229166729. 3502906
19166815/355253229166810. 350290619167649/355253229167644. 350290619168050/355253229168055. 350290619168076/355253229168071. 3502
90619168126/355253229168121. 350290619168134/355253229168139. 350290619168142/355253229168147. 350290619168183/355253229168188. 3
50290619168191/355253229168196. 350290619168209/355253229168204. 350290619168217/355253229168212. 350290619168225/355253229168220
. 350290619168233/355253229168238. 350290619168241/355253229168246.350290619168258/355253229168253. 350290619168308/3552532291683
03. 350290619168316/355253229168311. 350290619168324/355253229168329. 350290619168332/355253229168337. 350290619168340/3552532291
68345. 350290619168357/355253229168352XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001824049-9
Espacio para uso exclusivo de la Entidad Recaudadora
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