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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
032024001233001-1
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. 116575014734507
43 . Año – Mes – Día
2024 – 09 – 04
44 . Documento de transporte
No. HKL040567
45 . Año – Mes – Día
2024 – 08 – 28
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
6900295253
52 . Año – Mes – Día
2024 – 08 – 26
53 . Cod. país
procedencia
351
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.
4.132.11
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.
170.00
72 . Peso neto kgs. dcms.
137.50
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
500.00
78 .Valor FOB
USD
22.003.12
79 . Valor fletes USD
1.145.80 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
95.658.512
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
95.658.512
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
1.12
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.146.92
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
23.150.04
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: 529368-DECL: 1835949-DO: 893120358241- 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: 3072170938. ID CONTENEDOR: 6077711879. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A065MLBDLTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A06 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL CLA(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
032024001233001
133. Feha: 202409 05
134 . Levante No. 032024001157792 135 . Fecha
2024 – 09 – 05
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 92032406627201
Fecha presentación 2024-09-05 16:55:44
Valor pagado $0.00
Fecha de Impresión: 2024-09-05 16:55:49
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001233001-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
RO, MODELO: SM-A065M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A065M/DS,LIGHT B LUE,LTC( QTY. 500,00 u )(5
00,00 PCE); IMEIS: 354106701107440/357809261107448. 354106701107457/357809261107455. 354106701107465/357809261107463. 35410670110
7473/357809261107471. 354106701107481/357809261107489. 354106701107499/357809261107497. 354106701107507/357809261107505. 35410670
1107515/357809261107513. 354106701107523/357809261107521. 354106701107531/357809261107539. 354106701107549/357809261107547. 35410
6701107556/357809261107554. 354106701107564/357809261107562. 354106701107572/357809261107570. 354106701107580/357809261107588. 35
4106701107598/357809261107596. 354106701107606/357809261107604. 354106701107614/357809261107612. 354106701107622/357809261107620.
354106701107630/357809261107638. 354106701107648/357809261107646. 354106701107655/357809261107653. 354106701107663/3578092611076
61. 354106701107671/357809261107679. 354106701107689/357809261107687. 354106701107697/357809 261107695. 354106701107705/357809261
107703. 354106701107713/357809261107711. 354106701107721/357809261107729. 354106701107739/357809261107737. 354106701107747/357809
261107745. 354106701107754/357809261107752. 354106701107762/357809261107760. 354106701107770/357809261107778. 354106701107788/357
809261107786. 354106701107796/357809261107794. 354106701107804/357809261107802. 354106701107812/357809261107810. 354106701107820/
357809261107828. 354106701107838/357809261107836. 354106701107846/357809261107844. 354106701107861/357809261107869. 3541067011078
79/357809261107877. 354106701107887/357809261107885. 354106701107895/357809261107893. 354106701107903/357809261107901. 3541067011
07911/357809261107919. 354106701107929/357809261107927. 354106701107937/357809261107935.354106701107945/357809261107943. 35410670
1107952/357809261107950. 354106701107960/357809261107968. 354106701107986/357809261107984. 354106701107994/357809261107992. 35410
6701108000/357809261108008. 354106701108018/357809261108016. 354106701108026/357809261108024. 354106701108034/357809261108032. 35
4106701108042/357809261108040. 354106701108059/357809261108057. 354106701108067/357809261108065. 354106701108075/357809261108073.
354106701108083/357809261108081. 354106701108091/357809261108099. 354106701108109/357809261108107. 354106701108117/3578092611081
15.354106701108125/357809261108123. 354106701108133/357809261108131. 354106701108141/357809261108149. 354106701108158/35780926110
8156. 354106701108166/357809261108164. 354106701108174/357809261108172. 354106701108182/357809261108180. 354106701108190/35780926
1108198. 354106701108208/357809261108206. 354106701108216/357809261108214. 354106701108232/357809261108230. 354106701108240/35780
9261108248. 354106701108265/357809261108263. 354106701108273/357809261108271. 354106701108281/357809261108289. 354106701108299/35
7809261108297. 354106701108307/357809261108305. 354106701108315/357809261108313. 354106701108323/357809261108321. 354106701108349
/357809261108347. 354106701108364/357809261108362. 354106701108372/357809261108370. 354106701108380/357809261108388. 354106701108
398/357809261108396. 354106701108406/357809261108404. 354106701105667/357809261105665. 354106701105675/357809261105673. 354106701
105717/357809261105715. 354106701105758/357809261105756. 354106701105766/357809261105764. 354106701105774/357809261105772. 354106
701105790/357809261105798. 354106701105808/357809261105806. 354106701105816/357809261105814. 354106701105824/357809261105822. 354
106701105832/357809261105830. 354106701105840/357809261105848. 354106701105857/357809261105855. 354106701105865/357809261105863.
354106701105881/357809261105889. 354106701105907/357809261105905. 354106701105923/357809261105921. 354106701105931/35780926110593
9. 354106701105949/357809261105947. 354106701105956/357809261105954. 354106701105964/357809261105962. 354106701105980/35780926110
5988. 354106701105998/357809261105996. 354106701106004/357809261106002. 354106701106012/357809261106010. 354106701106020/35780926
1106028. 354106701106038/357809261106036. 354106701106046/357809261106044.354106701106061/357809261106069. 354106701106079/357809
261106077. 354106701106087/357809261106085. 354106701106095/357809261106093. 354106701106103/357809261106101. 354106701106111/357
809261106119. 354106701106129/357809261106127. 354106701106145/357809261106143. 354106701106186/357809261106184. 354106701106210/
357809261106218. 354106701106228/357809261106226. 354106701106269/357809261106267. 354106701106285/357809261106283. 3541067011062
93/357809261106291. 354106701106301/357809261106309. 354106701106335/357809261106333. 354106701106343/357809261106341.35410670110
6376/357809261106374. 354106701106392/357809261106390. 354106701106418/357809261106416. 354106701106426/357809261106424. 35410670
1106434/357809261106432. 354106701106459/357809261106457. 354106701106467/357809261106465. 354106701106483/357809261106481. 35410
6701106509/357809261106507. 354106701106525/357809261106523. 354106701106533/357809261106531. 354106701106541/357809261106549. 35
4106701106558/357809261106556. 354106701106566/357809261106564. 354106701106574/357809261106572. 354106701106582/357809261106580.
354106701106590/357809261106598. 354106701106608/357809261106606. 354106701106616/357809261106614. 354106701106624/3578092611066
22. 354106701106640/357809261106648. 354106701106665/357809261106663. 354106701106673/357809261106671. 354106701106681/3578092611
06689. 354106701106699/357809261106697. 354106701106707/357809261106705. 354106701106715/357809261106713. 354106701106723/3578092
61106721. 354106701106731/357809261106739. 354106701106756/357809261106754. 354106701106764/357809261106762. 354106701106772/3578
09261106770. 354106701106798/357809261106796. 354106701106806/357809261106804. 354106701106822/357809261106820. 354106701106830/3
57809261106838. 354106701106848/357809261106846. 354106701106855/357809261106853. 354106701106863/357809261106861. 35410670110688
9/357809261106887. 354106701106897/357809261106895. 354106701106905/357809261106903. 354106701106913/357809261106911. 35410670110
6921/357809261106929. 354106701106939/357809261106937. 354106701106947/357809261106945. 354106701106954/357809261106952. 35410670
1106962/357809261106960. 354106701106970/357809261106978. 354106701106988/357809261106986. 354106701106996/357809261106994. 35410
6701107002/357809261107000. 354106701107010/357809261107018.354106701107028/357809261107026. 354106701107036/357809261107034. 354
106701107044/357809261107042. 354106701107051/357809261107059. 354106701107077/357809261107075. 354106701107085/357809261107083.
354106701107093/357809261107091. 354106701107101/357809261107109. 354106701107119/357809261107117. 354106701107127/35780926110712
5. 354106701107135/357809261107133. 354106701107150/357809261107158. 354106701107168/357809261107166. 354106701107176/35780926110
7174. 354106701107184/357809261107182. 354106701107192/357809261107190. 354106701107200/357809261107208.354106701107218/357809261
107216. 354106701107226/357809261107224. 354106701107234/357809261107232. 354106701107242/357809261107240. 354106701107259/357809
261107257. 354106701107267/357809261107265. 354106701107275/357809261107273. 354106701107283/357809261107281. 354106701107291/357
809261107299. 354106701107309/357809261107307. 354106701107317/357809261107315. 354106701107325/357809261107323. 354106701107333/
357809261107331. 354106701107341/357809261107349. 354106701107358/357809261107356. 354106701107366/357809261107364. 3541067011073
74/357809261107372. 354106701107390/357809261107398. 354106701107408/357809261107406. 354106701107416/357809261107414. 3541067011
07424/357809261107422. 354106701107432/357809261107430. 354106701103837/357809261103835. 354106701103852/357809261103850. 3541067
01103878/357809261103876. 354106701103894/357809261103892. 354106701103910/357809261103918. 354106701103969/357809261103967. 3541
06701103977/357809261103975. 354106701103985/357809261103983. 354106701103993/357809261103991. 354106701104009/357809261104007. 3
54106701104017/357809261104015. 354106701104025/357809261104023. 354106701104033/357809261104031. 354106701104041/357809261104049
. 354106701104066/357809261104064. 354106701104074/357809261104072. 354106701104082/357809261104080. 354106701104090/357809261104
098. 354106701104108/357809261104106. 354106701104116/357809261104114. 354106701104124/357809261104122. 354106701104132/357809261
104130. 354106701104165/357809261104163. 354106701104173/357809261104171. 354106701104199/357809261104197. 354106701104215/357809
261104213. 354106701104223/357809261104221. 354106701104231/357809261104239. 354106701104249/357809261104247. 354106701104264/357
809261104262. 354106701104272/357809261104270.354106701104280/357809261104288. 354106701104298/357809261104296. 354106701104306/3
57809261104304. 354106701104322/357809261104320. 354106701104330/357809261104338. 354106701104348/357809261104346. 35410670110436
3/357809261104361. 354106701104389/357809261104387. 354106701104405/357809261104403. 354106701104413/357809261104411. 35410670110
4421/357809261104429. 354106701104447/357809261104445. 354106701104462/357809261104460. 354106701104470/357809261104478. 35410670
1104496/357809261104494. 354106701108414/357809261108412. 354106701108422/357809261108420.354106701108430/357809261108438. 354106
701108448/357809261108446. 354106701108455/357809261108453. 354106701108463/357809261108461. 354106701108471/357809261108479. 354
106701108489/357809261108487. 354106701108497/357809261108495. 354106701108505/357809261108503. 354106701108513/357809261108511.
354106701108521/357809261108529. 354106701108539/357809261108537. 354106701108547/357809261108545. 354106701108554/35780926110855
032024001233001-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001233001-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
2. 354106701108562/357809261108560. 354106701108570/357809261108578. 354106701108588/357809261108586. 354106701108596/35780926110
8594. 354106701108604/357809261108602. 354106701108612/357809261108610. 354106701108620/357809261108628. 354106701108638/35780926
1108636. 354106701108646/357809261108644. 354106701108653/357809261108651. 354106701108661/357809261108669. 354106701108679/35780
9261108677. 354106701108687/357809261108685. 354106701108695/357809261108693. 354106701108703/357809261108701. 354106701108729/35
7809261108727. 354106701108745/357809261108743. 354106701108752/357809261108750. 354106701108760/357809261108768. 354106701108778
/357809261108776. 354106701108794/357809261108792. 354106701108802/357809261108800. 354106701108810/357809261108818. 354106701108
836/357809261108834. 354106701108869/357809261108867. 354106701108885/357809261108883. 354106701108893/357809261108891. 354106701
108919/357809261108917. 354106701108927/357809261108925. 354106701108943/357809261108941. 354106701108950/357809261108958. 354106
701108976/357809261108974. 354106701108992/357809261108990. 354106701109040/357809261109048. 354106701109057/357809261109055. 354
106701109107/357809261109105. 354106701109115/357809261109113. 354106701109156/357809261109154. 354106701109198/357809261109196.
354106701109230/357809261109238.354106701109248/357809261109246. 354106701109289/357809261109287. 354106701109305/357809261109303
. 354106701109313/357809261109311. 354106701109339/357809261109337. 354106701109362/357809261109360. 354106701109396/357809261109
394. 354106701109453/357809261109451. 354106701109479/357809261109477. 354106701109487/357809261109485. 354106701109503/357809261
109501. 354106701109511/357809261109519. 354106701109529/357809261109527. 354106701109537/357809261109535. 354106701109545/357809
261109543. 354106701109552/357809261109550. 354106701109560/357809261109568.354106701109578/357809261109576. 354106701109586/3578
09261109584. 354106701109602/357809261109600. 354106701109610/357809261109618. 354106701109636/357809261109634. 354106701109644/3
57809261109642. 354106701109651/357809261109659. 354106701109693/357809261109691. 354106701109701/357809261109709. 35410670110971
9/357809261109717. 354106701109727/357809261109725. 354106701109735/357809261109733. 354106701109743/357809261109741. 35410670110
9750/357809261109758. 354106701109768/357809261109766. 354106701109776/357809261109774. 354106701109784/357809261109782. 35410670
1109792/357809261109790. 354106701109800/357809261109808. 354106701109818/357809261109816. 354106701109826/357809261109824. 35410
6701109834/357809261109832. 354106701109842/357809261109840. 354106701109859/357809261109857. 354106701109867/357809261109865. 35
4106701109883/357809261109881. 354106701109891/357809261109899. 354106701109925/357809261109923. 354106701109933/357809261109931.
354106701109958/357809261109956. 354106701109966/357809261109964. 354106701109974/357809261109972. 354106701109982/3578092611099
80. 354106701109990/357809261109998. 354106701110006/357809261110004. 354106701110014/357809261110012. 354106701110022/3578092611
10020. 354106701110030/357809261110038. 354106701110048/357809261110046. 354106701110055/357809261110053. 354106701110063/3578092
61110061. 354106701110071/357809261110079. 354106701110089/357809261110087. 354106701110097/357809261110095. 354106701110105/3578
09261110103. 354106701110113/357809261110111. 354106701110121/357809261110129. 354106701110139/357809261110137. 354106701110147/3
57809261110145. 354106701110154/357809261110152. 354106701110162/357809261110160. 354106701110170/357809261110178. 35410670111018
8/357809261110186.354106701110196/357809261110194. 354106701110204/357809261110202. 354106701110212/357809261110210. 354106701110
220/357809261110228. 354106701110238/357809261110236. 354106701110246/357809261110244. 354106701110253/357809261110251. 354106701
110261/357809261110269. 354106701110279/357809261110277. 354106701110287/357809261110285. 354106701110295/357809261110293. 354106
701110303/357809261110301. 354106701110311/357809261110319. 354106701110329/357809261110327. 354106701110337/357809261110335. 354
106701110352/357809261110350. 354106701110360/357809261110368.354106701110378/357809261110376. 354106701110386/357809261110384. 3
54106701110394/357809261110392. 354106701110402/357809261110400. 354106701110410/357809261110418. 354106701110428/357809261110426
. 354106701110436/357809261110434. 354106701110444/357809261110442. 354106701110451/357809261110459. 354106701110469/357809261110
467. 354106701110477/357809261110475. 354106701110493/357809261110491. 354106701110501/357809261110509. 354106701110519/357809261
110517. 354106701110535/357809261110533. 354106701110543/357809261110541. 354106701110550/357809261110558. 354106701110576/357809
261110574. 354106701110584/357809261110582. 354106701110592/357809261110590. 354106701110600/357809261110608. 354106701110618/357
809261110616. 354106701110634/357809261110632. 354106701110659/357809261110657. 354106701110675/357809261110673. 354106701110717/
357809261110715. 354106701110725/357809261110723. 354106701110766/357809261110764. 354106701110808/357809261110806. 3541067011108
24/357809261110822. 354106701110832/357809261110830. 354106701110857/357809261110855. 354106701110873/357809261110871. 3541067011
10881/357809261110889. 354106701110899/357809261110897. 354106701110915/357809261110913. 354106701110964/357809261110962. 3541067
01110998/357809261110996. 354106701111004/357809261111002. 354106701104520/357809261104528. 354106701104538/357809261104536. 3541
06701104561/357809261104569. 354106701104579/357809261104577. 354106701104595/357809261104593. 354106701104603/357809261104601. 3
54106701104637/357809261104635. 354106701104645/357809261104643. 354106701104652/357809261104650. 354106701104686/357809261104684
. 354106701104702/357809261104700. 354106701104728/357809261104726. 354106701104736/357809261104734. 354106701104751/357809261104
759.354106701104785/357809261104783. 354106701104793/357809261104791. 354106701104827/357809261104825. 354106701104835/3578092611
04833. 354106701104843/357809261104841. 354106701104850/357809261104858. 354106701104868/357809261104866. 354106701104900/3578092
61104908. 354106701104918/357809261104916. 354106701104926/357809261104924. 354106701104934/357809261104932. 354106701104942/3578
09261104940. 354106701104967/357809261104965. 354106701104991/357809261104999. 354106701105022/357809261105020. 354106701105048/3
57809261105046. 354106701105097/357809261105095.354106701105105/357809261105103. 354106701105113/357809261105111. 354106701105139
/357809261105137. 354106701105154/357809261105152. 354106701105204/357809261105202. 354106701105337/357809261105335. 354106701105
410/357809261105418. 354106701105436/357809261105434. 354106701105469/357809261105467. 354106701105477/357809261105475. 354106701
105519/357809261105517. 354106701105543/357809261105541. 354106701105592/357809261105590. 354106701105634/357809261105632XXXXXXXX
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032024001233001-1
Espacio para uso exclusivo de la Entidad Recaudadora
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