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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
032025000186085-3
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. 116575015253449
43 . Año – Mes – Día
2025 – 02 – 11
44 . Documento de transporte
No. DEL8168927
45 . Año – Mes – Día
2025 – 02 – 04
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
9103215735
52 . Año – Mes – Día
2025 – 02 – 04
53 . Cod. país
procedencia
361
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.
4.170.01
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
361
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.
107.00
72 . Peso neto kgs. dcms.
100.00
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
67.704.19
79 . Valor fletes USD
839.95 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
285.843.594
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
285.843.594
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
3.32
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
843.27
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
68.547.46
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: 546738-DECL: 1884148-DO: 893102925251- 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: 3082845935. ID DELIVERY: 6080300039. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A356ELVGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A35 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VIOLET(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
032025000186085
133. Feha: 202502 07
134 . Levante No. 032025000199802 135 . Fecha
2025 – 02 – 12
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 92032501048835
Fecha presentación 2025-02-07 15:03:05
Valor pagado $0.00
Fecha de Impresión: 2025-02-12 15:26:31
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000186085-3
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
A CLARO, MODELO:SM-A356E/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A356E/DS,LIGHT VIOLET,LTC( QTY. 300,00
u )(300,00 PCE); IMEIS: 350722246433317/350884526433316. 350722246433366/350884526433365. 350722246433374/350884526433373. 35072
2246433465/350884526433464. 350722246433499/350884526433498. 350722246433531/350884526433530. 350722246433556/350884526433555. 35
0722246433580/350884526433589. 350722246433689/350884526433688. 350722246433804/350884526433803. 350722246433838/350884526433837.
350722246433853/350884526433852. 350722246433903/350884526433902. 350722246433929/350884526433928. 350722246433952/3508845264339
51. 350722246433978/350884526433977. 350722246433994/350884526433993.350722246434000/350884526434009. 350722246434018/35088452643
4017. 350722246434091/350884526434090. 350722246434117/350884526434116. 350722246434125/350884526434124. 350722246434190/35088452
6434199. 350722246434232/350884526434231. 350722246434265/350884526434264. 350722246434273/ 350884526434272. 350722246434281/3508
84526434280. 350722246434299/350884526434298. 350722246434307/350884526434306. 350722246434349/350884526434348. 350722246434364/3
50884526434363. 350722246434463/350884526434462. 350722246434497/350884526434496. 350722246438803/350884526438802.350722246438829
/350884526438828. 350722246438878/350884526438877. 350722246438951/350884526438950. 350722246439124/350884526439123. 350722246439
504/350884526439503. 350722246439629/350884526439628. 350722246439645/350884526439644. 350722246439918/350884526439917. 350722246
440072/350884526440071. 350722246440379/350884526440378. 350722246440429/350884526440428. 350722246440510/350884526440519. 350722
246441088/350884526441087. 350722246441104/350884526441103. 350722246441120/350884526441129. 350722246441252/350884526441251. 350
722246441385/350884526441384. 350722246441633/350884526441632. 350722246441658/350884526441657. 350722246441724/350884526441723.
350722246441799/350884526441798. 350722246441906/350884526441905. 350722246442136/350884526442135. 350722246442169/35088452644216
8. 350722246442185/350884526442184. 350722246442276/350884526442275. 350722246442417/350884526442416. 350722246442466/35088452644
2465. 350722246442508/350884526442507. 350722246442532/350884526442531. 350722246442565/350884526442564. 350722246442607/35088452
6442606. 350722246442615/350884526442614. 350722246442631/350884526442630. 350722246442755/350884526442754. 350722246442920/35088
4526442929. 350722246443126/350884526443125. 350722246443381/350884526443380. 350722246443621/350884526443620. 350722246443654/35
0884526443653. 350722246443670/350884526443679. 350722246443688/350884526443687. 350722246443696/350884526443695. 350722246443712
/350884526443711. 350722246443720/350884526443729. 350722246443738/350884526443737. 350722246443829/350884526443828. 350722246443
852/350884526443851. 350722246443860/350884526443869. 350722246443928/350884526443927. 350722246443936/350884526443935. 350722246
443951/350884526443950. 350722246444041/350884526444040.350722246444058/350884526444057. 350722246444074/350884526444073. 3507222
46444090/350884526444099. 350722246444108/350884526444107. 350722246444132/350884526444131. 350722246444140/350884526444149. 3507
22246444215/350884526444214. 350722246444231/350884526444230. 350722246444272/350884526444271. 350722246444355/350884526444354. 3
50722246444397/350884526444396. 350722246444421/350884526444420. 350722246444496/350884526444495. 350722246444504/350884526444503
. 350722246444512/350884526444511. 350722246444538/350884526444537. 350722246444637/350884526444636.350722246444645/3508845264446
44. 350722246444660/350884526444669. 350722246444686/350884526444685. 350722246444694/350884526444693. 350722246444710/3508845264
44719. 350722246444728/350884526444727. 350722246444736/350884526444735. 350722246444785/350884526444784. 350722246444827/3508845
26444826. 350722246444850/350884526444859. 350722246445022/350884526445021. 350722246445030/350884526445039. 350722246445147/3508
84526445146. 350722246445162/350884526445161. 350722246445212/350884526445211. 350722246445238/350884526445237. 350722246445311/3
50884526445310. 350722246445402/350884526445401. 350722246445410/350884526445419. 350722246445444/350884526445443. 35072224644547
7/350884526445476. 350722246445485/350884526445484. 350722246445600/350884526445609. 350722246445642/350884526445641. 35072224644
5709/350884526445708. 350722246445766/350884526445765. 350722246445816/350884526445815. 350722246446079/350884526446078. 35072224
6446244/350884526446243. 350722246446319/350884526446318. 350722246446350/350884526446359. 350722246446368/350884526446367. 35072
2246446384/350884526446383. 350722246446400/350884526446409. 350722246446426/350884526446425. 350722246446459/350884526446458. 35
0722246446483/350884526446482. 350722246446525/350884526446524. 350722246446533/350884526446532. 350722246446541/350884526446540.
350722246446558/350884526446557. 350722246446574/350884526446573. 350722246449560/350884526449569. 350722246449610/3508845264496
19. 350722246449875/350884526449874. 350722246449909/350884526449908. 350722246450048/350884526450047. 350722246450105/3508845264
50104. 350722246450147/350884526450146. 350722246452614/350884526452613. 350722246452788/350884526452787. 350722246452820/3508845
26452829. 350722246452879/350884526452878.350722246452895/350884526452894. 350722246453166/350884526453165. 350722246453547/35088
4526453546. 350722246453745/350884526453744. 350722246453836/350884526453835. 350722246453885/350884526453884. 350722246453968/35
0884526453967. 350722246453984/350884526453983. 350722246454057/350884526454056. 350722246454073/350884526454072. 350722246454115
/350884526454114. 350722246454123/350884526454122. 350722246454149/350884526454148. 350722246454164/350884526454163. 350722246454
263/350884526454262. 350722246454339/350884526454338. 350722246454347/350884526454346.350722246454362/350884526454361. 3507222464
54396/350884526454395. 350722246454453/350884526454452. 350722246454891/350884526454890. 350722246454941/350884526454940. 3507222
46454974/350884526454973. 350722246455062/350884526455061. 350722246455195/350884526455194. 350722246455229/350884526455228. 3507
22246455336/350884526455335. 350722246455450/350884526455459. 350722246455484/350884526455483. 350722246455567/350884526455566. 3
50722246455591/350884526455590. 350722246455633/350884526455632. 350722246455799/350884526455798. 350722246455906/350884526455905
. 350722246455914/350884526455913. 350722246455997/350884526455996. 350722246456110/350884526456119. 350722246456144/350884526456
143. 350722246456201/350884526456200. 350722246456318/350884526456317. 350722246456334/350884526456333. 350722246456375/350884526
456374. 350722246456409/350884526456408. 350722246456433/350884526456432. 350722246456458/350884526456457. 350722246456516/350884
526456515. 350722246456573/350884526456572. 350722246456599/350884526456598. 350722246456615/350884526456614. 350722246456623/350
884526456622. 350722246456631/350884526456630. 350722246456649/350884526456648. 350722246456714/350884526456713. 350722246456755/
350884526456754. 350722246456797/350884526456796. 350722246456813/350884526456812. 350722246456839/350884526456838. 3507222464568
47/350884526456846. 350722246456938/350884526456937. 350722246457068/350884526457067. 350722246457084/350884526457083. 3507222464
57167/350884526457166. 350722246457258/350884526457257. 350722246457266/350884526457265. 350722246457274/350884526457273. 3507222
46457282/350884526457281. 350722246457290/350884526457299. 350722246457308/350884526457307. 350722246457316/350884526457315. 3507
22246457357/350884526457356.350722246457365/350884526457364. 350722246457399/350884526457398. 350722246457480/350884526457489. 35
0722246457654/350884526457653. 350722246457720/350884526457729. 350722246457738/350884526457737. 350722246457779/350884526457778.
350722246457829/350884526457828. 350722246458041/350884526458040. 350722246459023/350884526459022. 350722246459593/3508845264595
92. 350722246459627/350884526459626. 350722246460369/350884526460368. 350722246503150/350884526503159. 350722246503424/3508845265
03423. 350722246503499/350884526503498. 350722246503515/350884526503514.350722246503549/350884526503548. 350722246503556/35088452
6503555. 350722246503622/350884526503621. 350722246503689/350884526503688. 350722246503788/350884526503787. 350722246503903/35088
4526503902. 350722246504018/350884526504017. 350722246504182/350884526504181. 350722246504190/350884526504199. 350722246504406/35
0884526504405. 350722246504554/350884526504553. 350722246430438/350884526430437. 350722246430495/350884526430494. 350722246430511
/350884526430510. 350722246430545/350884526430544. 350722246430578/350884526430577. 350722246430594/350884526430593. 350722246430
669/350884526430668. 350722246430792/350884526430791. 350722246430818/350884526430817. 350722246430826/350884526430825. 350722246
430974/350884526430973. 350722246431006/350884526431005. 350722246431071/350884526431070. 350722246431097/350884526431096. 350722
246431295/350884526431294. 350722246431329/350884526431328. 350722246431386/350884526431385. 350722246431493/350884526431492. 350
722246431717/350884526431716. 350722246431725/350884526431724. 350722246431733/350884526431732. 350722246431832/350884526431831.
350722246431840/350884526431849. 350722246431907/350884526431906. 350722246431964/350884526431963. 350722246431980/35088452643198
9. 350722246432004/350884526432003. 350722246432012/350884526432011. 350722246432145/350884526432144. 350722246432160/35088452643
2169. 350722246432194/350884526432193. 350722246432202/350884526432201. 350722246432210/350884526432219. 350722246432228/35088452
032025000186085-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000186085-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
6432227. 350722246432244/350884526432243. 350722246432269/350884526432268. 350722246432442/350884526432441. 350722246432731/35088
4526432730. 350722246433044/350884526433043. 350722246433051/350884526433050. 350722246433101/350884526433100. 350722246433143/35
0884526433142.350722246433176/350884526433175. 350722246433218/350884526433217. 350722246433275/350884526433274XXXXXXXXXXXXXXXXXX
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032025000186085-3
Espacio para uso exclusivo de la Entidad Recaudadora
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