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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
032024001823897-3
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. 116575015128959
43 . Año – Mes – Día
2024 – 12 – 30
44 . Documento de transporte
No. T61724Q02200
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
6900327274
52 . Año – Mes – Día
2024 – 12 – 17
53 . Cod. país
procedencia
215
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
169
56 . Cod. Depto
destino
0
57 . Empresa transportadora
TAMPA CARGO S.A.S.
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.
138.00
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
27.726.76
79 . Valor fletes USD
1.178.52 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
1.179.92
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: 542404-DECL: 1871840-DO: 893130857241- 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: 3079840909. ID DELIVERY: 6079688441. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A057MZSHLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A05s DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, MOD(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
032024001823897
133. Feha: 202412 27
134 . Levante No. 032024001740437 135 . Fecha
2024 – 12 – 31
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 92032409682805
Fecha presentación 2024-12-27 18:37:33
Valor pagado $0.00
Fecha de Impresión: 2024-12-31 10:29:22
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001823897-3
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ELO: SM-A057M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A057M/DS,SILVER,LTC( QTY. 400,00 u )(400,00 PCE);
IMEIS: 350290619261848/355253229261843. 350290619262861/355253229262866. 350290619263083/355253229263088. 350290619263224/355253
229263229. 350290619263240/355253229263245. 350290619263364/355253229263369. 350290619263372/355253229263377. 350290619263661/355
253229263666. 350290619263752/355253229263757. 350290619263919/355253229263914. 350290619263943/355253229263948. 350290619263950/
355253229263955. 350290619263968/355253229263963. 350290619263984/355253229263989. 350290619264024/355253229264029. 3502906192640
32/355253229264037. 350290619264057/355253229264052. 350290619264156/355253229264151. 350290619264164/355253229264169. 3502906192
64180/355253229264185. 350290619264214/355253229264219. 350290619264222/355253229264227. 350290619264255/355253229264250. 3502906
19264271/355253229264276. 350290619264305/355253229264300. 350290619264313/355253229264318. 3 50290619264339/355253229264334. 350
290619264347/355253229264342. 350290619264388/355253229264383. 350290619264412/355253229264417. 350290619264461/355253229264466.
350290619264503/355253229264508. 350290619264511/355253229264516. 350290619264552/355253229264557. 350290619264560/35525322926456
5. 350290619264586/355253229264581. 350290619264594/355253229264599. 350290619264636/355253229264631. 350290619264651/35525322926
4656. 350290619264669/355253229264664. 350290619264693/355253229264698. 350290619264701/355253229264706. 350290619264743/35525322
9264748.350290619264750/355253229264755. 350290619275830/355253229275835. 350290619275848/355253229275843. 350290619276960/355253
229276965. 350290619278149/355253229278144. 350290619278180/355253229278185. 350290619278388/355253229278383. 350290619278735/355
253229278730. 350290619278883/355253229278888. 350290619279071/355253229279076. 350290619279154/355253229279159. 350290619279196/
355253229279191. 350290619279204/355253229279209. 350290619279246/355253229279241. 350290619279261/355253229279266. 3502906192792
87/355253229279282. 350290619279295/355253229279290.350290619279311/355253229279316. 350290619279329/355253229279324. 35029061927
9337/355253229279332. 350290619279345/355253229279340. 350290619279352/355253229279357. 350290619279360/355253229279365. 35029061
9279378/355253229279373. 350290619279386/355253229279381. 350290619279394/355253229279399. 350290619279402/355253229279407. 35029
0619279410/355253229279415. 350290619279436/355253229279431. 350290619279444/355253229279449. 350290619279451/355253229279456. 35
0290619279469/355253229279464. 350290619279477/355253229279472. 350290619279501/355253229279506. 350290619279519/355253229279514.
350290619279527/355253229279522. 350290619279535/355253229279530. 350290619279543/355253229279548. 350290619279550/3552532292795
55. 350290619279568/355253229279563. 350290619279576/355253229279571. 350290619279592/355253229279597. 350290619279600/3552532292
79605. 350290619279626/355253229279621. 350290619279634/355253229279639. 350290619249751/355253229249756. 350290619251583/3552532
29251588. 350290619251666/355253229251661. 350290619251690/355253229251695. 350290619251708/355253229251703. 350290619251732/3552
53229251737. 350290619251757/355253229251752. 350290619252839/355253229252834. 350290619254058/355253229254053. 350290619254249/3
55253229254244. 350290619254314/355253229254319. 350290619254686/355253229254681. 350290619254884/355253229254889. 35029061925517
0/355253229255175. 350290619255188/355253229255183. 350290619255261/355253229255266. 350290619255287/355253229255282. 35029061925
5451/355253229255456. 350290619255519/355253229255514. 350290619255535/355253229255530. 350290619255543/355253229255548. 35029061
9255634/355253229255639. 350290619255642/355253229255647. 350290619255659/355253229255654. 350290619255667/355253229255662.350290
619255675/355253229255670. 350290619255691/355253229255696. 350290619255709/355253229255704. 350290619255717/355253229255712. 350
290619255725/355253229255720. 350290619255733/355253229255738. 350290619255741/355253229255746. 350290619255758/355253229255753.
350290619255766/355253229255761. 350290619255782/355253229255787. 350290619255808/355253229255803. 350290619255857/35525322925585
2. 350290619255899/355253229255894. 350290619255915/355253229255910. 350290619255923/355253229255928. 350290619255949/35525322925
5944. 350290619255964/355253229255969.350290619255998/355253229255993. 350290619256004/355253229256009. 350290619264768/355253229
264763. 350290619264826/355253229264821. 350290619264842/355253229264847. 350290619264859/355253229264854. 350290619264867/355253
229264862. 350290619264875/355253229264870. 350290619264883/355253229264888. 350290619264909/355253229264904. 350290619264917/355
253229264912. 350290619264925/355253229264920. 350290619264933/355253229264938. 350290619264966/355253229264961. 350290619264974/
355253229264979. 350290619264982/355253229264987. 350290619264990/355253229264995. 350290619266615/355253229266610. 3502906192676
47/355253229267642. 350290619268009/355253229268004. 350290619268066/355253229268061. 350290619268140/355253229268145. 3502906192
68348/355253229268343. 350290619268371/355253229268376. 350290619268645/355253229268640. 350290619268660/355253229268665. 3502906
19268728/355253229268723. 350290619268736/355253229268731. 350290619268801/355253229268806. 350290619268967/355253229268962. 3502
90619268983/355253229268988. 350290619268991/355253229268996. 350290619269007/355253229269002. 350290619269015/355253229269010. 3
50290619269064/355253229269069. 350290619269080/355253229269085. 350290619269098/355253229269093. 350290619269114/355253229269119
. 350290619269122/355253229269127. 350290619269650/355253229269655. 350290619269676/355253229269671. 350290619269700/355253229269
705. 350290619269759/355253229269754. 350290619269866/355253229269861. 350290619271250/355253229271255. 350290619271482/355253229
271487. 350290619271490/355253229271495. 350290619271599/355253229271594. 350290619271730/355253229271735. 350290619271755/355253
229271750. 350290619271789/355253229271784. 350290619271995/355253229271990. 350290619272076/355253229272071.350290619272134/3552
53229272139. 350290619272332/355253229272337. 350290619272357/355253229272352. 350290619272381/355253229272386. 350290619272423/3
55253229272428. 350290619272449/355253229272444. 350290619272464/355253229272469. 350290619272472/355253229272477. 35029061927249
8/355253229272493. 350290619272506/355253229272501. 350290619272522/355253229272527. 350290619272548/355253229272543. 35029061927
2555/355253229272550. 350290619272563/355253229272568. 350290619272605/355253229272600. 350290619272613/355253229272618. 35029061
9272621/355253229272626.350290619272639/355253229272634. 350290619272647/355253229272642. 350290619272654/355253229272659. 350290
619272662/355253229272667. 350290619272688/355253229272683. 350290619272704/355253229272709. 350290619272712/355253229272717. 350
290619272720/355253229272725. 350290619272738/355253229272733. 350290619272795/355253229272790. 350290619272803/355253229272808.
350290619272829/355253229272824. 350290619272837/355253229272832. 350290619272845/355253229272840. 350290619272852/35525322927285
7. 350290619272860/355253229272865. 350290619272878/355253229272873. 350290619272894/355253229272899. 350290619272910/35525322927
2915. 350290619272928/355253229272923. 350290619256012/355253229256017. 350290619256038/355253229256033. 350290619256053/35525322
9256058. 350290619256079/355253229256074. 350290619256103/355253229256108. 350290619256111/355253229256116. 350290619256137/35525
3229256132. 350290619256145/355253229256140. 350290619256152/355253229256157. 350290619256160/355253229256165. 350290619256210/35
5253229256215. 350290619256236/355253229256231. 350290619256251/355253229256256. 350290619256269/355253229256264. 350290619256475
/355253229256470. 350290619256483/355253229256488. 350290619256509/355253229256504. 350290619258471/355253229258476. 350290619259
370/355253229259375. 350290619259560/355253229259565. 350290619259636/355253229259631. 350290619259768/355253229259763. 350290619
259800/355253229259805. 350290619259859/355253229259854. 350290619259867/355253229259862. 350290619259925/355253229259920. 350290
619259974/355253229259979. 350290619259982/355253229259987. 350290619260006/355253229260001. 350290619260022/355253229260027. 350
290619260030/355253229260035. 350290619260089/355253229260084. 350290619260097/355253229260092.350290619260147/355253229260142. 3
50290619260196/355253229260191. 350290619260246/355253229260241. 350290619260436/355253229260431. 350290619260618/355253229260613
. 350290619260733/355253229260738. 350290619261111/355253229261116. 350290619261186/355253229261181. 350290619261210/355253229261
215. 350290619261301/355253229261306. 350290619261830/355253229261835. 350290619279642/355253229279647. 350290619279659/355253229
279654. 350290619279675/355253229279670. 350290619279717/355253229279712. 350290619279766/355253229279761. 350290619279774/355253
229279779.350290619279782/355253229279787. 350290619279808/355253229279803. 350290619279923/355253229279928. 350290619280004/3552
53229280009. 350290619280012/355253229280017. 350290619280111/355253229280116. 350290619280228/355253229280223. 350290619280236/3
55253229280231. 350290619280244/355253229280249. 350290619282091/355253229282096. 350290619282489/355253229282484. 35029061928318
0/355253229283185. 350290619283446/355253229283441. 350290619283560/355253229283565. 350290619283776/355253229283771. 35029061928
4717/355253229284712. 350290619286456/355253229286451. 350290619286522/355253229286527. 350290619286530/355253229286535. 35029061
032024001823897-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001823897-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
9286548/355253229286543. 350290619286555/355253229286550. 350290619286563/355253229286568. 350290619286571/355253229286576. 35029
0619286589/355253229286584. 350290619286597/355253229286592. 350290619286621/355253229286626. 350290619286647/355253229286642. 35
0290619286654/355253229286659. 350290619286670/355253229286675. 350290619286704/355253229286709. 350290619286720/355253229286725.
350290619286746/355253229286741. 350290619286761/355253229286766. 350290619286787/355253229286782. 350290619286837/3552532292868
32. 350290619286894/355253229286899. 350290619286902/355253229286907. 350290619286928/355253229286923. 350290619286944/3552532292
86949. 350290619286951/355253229286956. 350290619286977/355253229286972. 350290619287009/355253229287004. 350290619287017/3552532
29287012. 350290619287025/355253229287020. 350290619287033/355253229287038. 350290619287041/355253229287046. 350290619287074/3552
53229287079. 350290619287090/355253229287095. 350290619287108/355253229287103. 350290619287116/355253229287111. 350290619287124/3
55253229287129. 350290619287157/355253229287152. 350290619287165/355253229287160.350290619287173/355253229287178. 350290619287181
/355253229287186. 350290619287199/355253229287194. 350290619287207/355253229287202. 350290619287215/355253229287210. 350290619287
223/355253229287228. 350290619287249/355253229287244. 350290619287264/355253229287269. 350290619287272/355253229287277. 350290619
287280/355253229287285. 350290619287298/355253229287293. 350290619287314/355253229287319. 350290619287322/355253229287327. 350290
619287330/355253229287335. 350290619287363/355253229287368. 350290619287371/355253229287376. 350290619287397/355253229287392.3502
90619287405/355253229287400. 350290619287413/355253229287418. 350290619287421/355253229287426. 350290619287439/355253229287434. 3
50290619287447/355253229287442. 350290619287454/355253229287459. 350290619287462/355253229287467. 350290619287470/355253229287475
. 350290619287488/355253229287483. 350290619287496/355253229287491. 350290619287595/355253229287590. 350290619288866/355253229288
861. 350290619272944/355253229272949. 350290619272951/355253229272956. 350290619272969/355253229272964. 350290619272977/355253229
272972. 350290619272985/355253229272980. 350290619272993/355253229272998. 350290619273009/355253229273004. 350290619273025/355253
229273020. 350290619273033/355253229273038. 350290619273058/355253229273053. 350290619273066/355253229273061. 350290619273082/355
253229273087. 350290619273108/355253229273103. 350290619273116/355253229273111. 350290619273124/355253229273129. 350290619273132/
355253229273137. 350290619273157/355253229273152. 350290619273165/355253229273160. 350290619273173/355253229273178. 3502906192731
81/355253229273186. 350290619273199/355253229273194. 350290619273215/355253229273210. 350290619273223/355253229273228. 3502906192
73231/355253229273236. 350290619273249/355253229273244. 350290619273256/355253229273251. 350290619273280/355253229273285. 3502906
19273306/355253229273301. 350290619273314/355253229273319. 350290619273322/355253229273327. 350290619273330/355253229273335. 3502
90619273348/355253229273343. 350290619274700/355253229274705. 350290619274775/355253229274770. 350290619274791/355253229274796. 3
50290619275046/355253229275041. 350290619275574/355253229275579. 350290619275699/355253229275694. 350290619275707/355253229275702
. 350290619275715/355253229275710. 350290619275723/355253229275728.350290619275731/355253229275736. 350290619275749/3552532292757
44. 350290619275822/355253229275827. 350290619290201/355253229290206. 350290619290425/355253229290420. 350290619290995/3552532292
90990. 350290619291886/355253229291881XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001823897-3
Espacio para uso exclusivo de la Entidad Recaudadora
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