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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
032025000195612-3
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. DEL8169077
45 . Año – Mes – Día
2025 – 02 – 05
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
9103218424
52 . Año – Mes – Día
2025 – 02 – 05
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.
4.150.99
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.
113.00
72 . Peso neto kgs. dcms.
99.00
73 . Código
embalaje
YY
74 . No. bultos
2
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
300.00
78 .Valor FOB
USD
67.971.17
79 . Valor fletes USD
887.05 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
285.843.605
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
285.843.605
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
3.33
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
890.38
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
68.861.55
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: 546904-DECL: 1884343-DO: 893103040251- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN)/ NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANC
IA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3082847836. ID DELIVERY:
6080320731. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A356ELVGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A35 5G DUOS(CON ACCESORIOS PA
RA USO Y NORMAL FUNCIONAMIENTO), COLOR: VIOLETA CLARO, MODELO: SM-A356E/DS, USO O DESTINO: PARA LA VENTA AL(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
032025000195612
133. Feha: 202502 10
134 . Levante No. 032025000198994 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 92032501105390
Fecha presentación 2025-02-10 15:06:14
Valor pagado $0.00
Fecha de Impresión: 2025-02-12 13:45:08
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000195612-3
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MAYOR Y AL DETAL./ /MOBILE,SM-A356E/DS,LIGHT VIOLET,LTC( QTY. 300,00 u )(300,00 PCE); IMEIS: 350722246435304/350884526435303. 35
0722246435312/350884526435311. 350722246435338/350884526435337. 350722246435346/350884526435345. 350722246435353/350884526435352.
350722246435361/350884526435360. 350722246435379/350884526435378. 350722246435395/350884526435394. 350722246435411/3508845264354
10. 350722246435429/350884526435428. 350722246435510/350884526435519. 350722246435569/350884526435568. 350722246435585/3508845264
35584. 350722246435619/350884526435618. 350722246435650/350884526435659. 350722246435718/350884526435717. 350722246435734/3508845
26435733. 350722246435791/350884526435790. 350722246435825/350884526435824. 350722246435858/350884526435857. 350722246435890/3508
84526435899. 350722246435924/350884526435923. 350722246435932/350884526435931. 350722246435940/350884526435949. 350722246435965/3
50884526435964. 350722246435981/350884526435980. 350722246436062/350884526436061. 350722246 436088/350884526436087. 3507222464360
96/350884526436095. 350722246436112/350884526436111. 350722246436336/350884526436335. 350722246436344/350884526436343. 3507222464
36377/350884526436376. 350722246437243/350884526437242. 350722246437714/350884526437713. 350722246437730/350884526437739. 3507222
46437755/350884526437754. 350722246437763/350884526437762. 350722246437771/350884526437770. 350722246437797/350884526437796.35072
2246437805/350884526437804. 350722246437813/350884526437812. 350722246437847/350884526437846. 350722246437862/350884526437861. 35
0722246437896/350884526437895. 350722246437904/350884526437903. 350722246437953/350884526437952. 350722246438001/350884526438000.
350722246438209/350884526438208. 350722246438720/350884526438729. 350722246438753/350884526438752. 350722246438795/3508845264387
94. 350722246438852/350884526438851. 350722246438860/350884526438869. 350722246438977/350884526438976. 350722246438993/3508845264
38992. 350722246439033/350884526439032.350722246439058/350884526439057. 350722246439082/350884526439081. 350722246439215/35088452
6439214. 350722246439249/350884526439248. 350722246439256/350884526439255. 350722246439306/350884526439305. 350722246439314/35088
4526439313. 350722246439389/350884526439388. 350722246439439/350884526439438. 350722246439553/350884526439552. 350722246439678/35
0884526439677. 350722246439702/350884526439701. 350722246439710/350884526439719. 350722246439744/350884526439743. 350722246439785
/350884526439784. 350722246439793/350884526439792. 350722246439835/350884526439834. 350722246439934/350884526439933. 350722246439
942/350884526439941. 350722246439967/350884526439966. 350722246440049/350884526440048. 350722246440064/350884526440063. 350722246
440148/350884526440147. 350722246440205/350884526440204. 350722246440320/350884526440329. 350722246440767/350884526440766. 350722
246441062/350884526441061. 350722246441203/350884526441202. 350722246441567/350884526441566. 350722246441617/350884526441616. 350
722246441773/350884526441772. 350722246441781/350884526441780. 350722246442334/350884526442333. 350722246442904/350884526442903.
350722246442987/350884526442986. 350722246442995/350884526442994. 350722246443050/350884526443059. 350722246443068/35088452644306
7. 350722246443084/350884526443083. 350722246443217/350884526443216. 350722246443233/350884526443232. 350722246443373/35088452644
3372. 350722246443472/350884526443471. 350722246443555/350884526443554. 350722246443597/350884526443596. 350722246443605/35088452
6443604. 350722246443639/350884526443638. 350722246443779/350884526443778. 350722246443787/350884526443786. 350722246443795/35088
4526443794. 350722246443845/350884526443844. 350722246443902/350884526443901. 350722246443944/350884526443943.350722246443969/350
884526443968. 350722246443993/350884526443992. 350722246444033/350884526444032. 350722246444124/350884526444123. 350722246444298/
350884526444297. 350722246444371/350884526444370. 350722246444447/350884526444446. 350722246444595/350884526444594. 3507222464446
03/350884526444602. 350722246444678/350884526444677. 350722246444793/350884526444792. 350722246444819/350884526444818. 3507222464
44843/350884526444842. 350722246444868/350884526444867. 350722246444892/350884526444891. 350722246444967/350884526444966. 3507222
46445295/350884526445294.350722246445360/350884526445369. 350722246445774/350884526445773. 350722246445857/350884526445856. 35072
2246445907/350884526445906. 350722246446061/350884526446060. 350722246446095/350884526446094. 350722246446293/350884526446292. 35
0722246446418/350884526446417. 350722246361740/350884526361749. 350722246425750/350884526425759. 350722246430461/350884526430460.
350722246430651/350884526430650. 350722246430800/350884526430809. 350722246431204/350884526431203. 350722246431451/3508845264314
50. 350722246431758/350884526431757. 350722246431790/350884526431799. 350722246431824/350884526431823. 350722246431881/3508845264
31880. 350722246431915/350884526431914. 350722246431923/350884526431922. 350722246432079/350884526432078. 350722246432087/3508845
26432086. 350722246432103/350884526432102. 350722246432111/350884526432110. 350722246432129/350884526432128. 350722246432137/3508
84526432136. 350722246432186/350884526432185. 350722246432251/350884526432250. 350722246432301/350884526432300. 350722246432574/3
50884526432573. 350722246432764/350884526432763. 350722246433085/350884526433084. 350722246433606/350884526433605. 35072224643402
6/350884526434025. 350722246434323/350884526434322. 350722246434471/350884526434470. 350722246434505/350884526434504. 35072224643
4521/350884526434520. 350722246434547/350884526434546. 350722246434638/350884526434637. 350722246434646/350884526434645. 35072224
6434695/350884526434694. 350722246434729/350884526434728. 350722246434786/350884526434785. 350722246435049/350884526435048. 35072
2246435056/350884526435055. 350722246435122/350884526435121. 350722246435171/350884526435170. 350722246435205/350884526435204. 35
0722246435221/350884526435220. 350722246435239/350884526435238. 350722246435247/350884526435246.350722246446491/350884526446490.
350722246446590/350884526446599. 350722246446657/350884526446656. 350722246449677/350884526449676. 350722246449719/35088452644971
8. 350722246449768/350884526449767. 350722246449891/350884526449890. 350722246449958/350884526449957. 350722246450089/35088452645
0088. 350722246450139/350884526450138. 350722246450980/350884526450989. 350722246451046/350884526451045. 350722246451053/35088452
6451052. 350722246451368/350884526451367. 350722246451376/350884526451375. 350722246451475/350884526451474. 350722246451509/35088
4526451508.350722246451533/350884526451532. 350722246451541/350884526451540. 350722246451574/350884526451573. 350722246451616/350
884526451615. 350722246451632/350884526451631. 350722246451657/350884526451656. 350722246451780/350884526451789. 350722246451855/
350884526451854. 350722246452143/350884526452142. 350722246452150/350884526452159. 350722246452549/350884526452548. 3507222464525
72/350884526452571. 350722246452622/350884526452621. 350722246452770/350884526452779. 350722246452960/350884526452969. 3507222464
53018/350884526453017. 350722246453026/350884526453025. 350722246453034/350884526453033. 350722246453059/350884526453058. 3507222
46453554/350884526453553. 350722246453687/350884526453686. 350722246453976/350884526453975. 350722246454024/350884526454023. 3507
22246454206/350884526454205. 350722246454230/350884526454239. 350722246454305/350884526454304. 350722246454313/350884526454312. 3
50722246454321/350884526454320. 350722246454446/350884526454445. 350722246454487/350884526454486. 350722246454842/350884526454841
. 350722246454859/350884526454858. 350722246454883/350884526454882. 350722246454909/350884526454908. 350722246454982/350884526454
981. 350722246454990/350884526454999. 350722246455039/350884526455038. 350722246455138/350884526455137. 350722246455237/350884526
455236. 350722246455245/350884526455244. 350722246455310/350884526455319. 350722246455401/350884526455400. 350722246455708/350884
526455707. 350722246455724/350884526455723. 350722246455922/350884526455921. 350722246456078/350884526456077. 350722246456136/350
884526456135. 350722246456219/350884526456218. 350722246456243/350884526456242. 350722246456276/350884526456275. 350722246456292/
350884526456291. 350722246456565/350884526456564. 350722246456664/350884526456663.350722246456680/350884526456689. 35072224645670
6/350884526456705. 350722246456748/350884526456747. 350722246456763/350884526456762. 350722246456771/350884526456770. 35072224645
6805/350884526456804. 350722246456854/350884526456853. 350722246456862/350884526456861. 350722246456888/350884526456887. 35072224
6456896/350884526456895. 350722246456920/350884526456929. 350722246456946/350884526456945. 350722246456961/350884526456960. 35072
2246456995/350884526456994. 350722246457019/350884526457018. 350722246457431/350884526457430. 350722246457464/350884526457463.350
722246457530/350884526457539. 350722246457548/350884526457547. 350722246457571/350884526457570. 350722246457597/350884526457596.
350722246457647/350884526457646. 350722246457670/350884526457679. 350722246457761/350884526457760. 350722246457837/35088452645783
6. 350722246457894/350884526457893. 350722246457902/350884526457901. 350722246457910/350884526457919. 350722246457977/35088452645
7976. 350722246458082/350884526458081. 350722246458116/350884526458115. 350722246458124/350884526458123. 350722246458181/35088452
6458180. 350722246458249/350884526458248. 350722246458355/350884526458354. 350722246458421/350884526458420. 350722246458447/35088
4526458446. 350722246458587/350884526458586. 350722246458652/350884526458651. 350722246458736/350884526458735. 350722246458876/35
032025000195612-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000195612-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
0884526458875. 350722246458900/350884526458909. 350722246458926/350884526458925. 350722246460955/350884526460954. 350722246503101
/350884526503100. 350722246503192/350884526503191. 350722246503358/350884526503357. 350722246503390/350884526503399. 350722246503
523/350884526503522. 350722246504224/350884526504223XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025000195612-3
Espacio para uso exclusivo de la Entidad Recaudadora
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