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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
032025000682160-5
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
1022943854
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. 116575015385316
43 . Año – Mes – Día
2025 – 03 – 21
44 . Documento de transporte
No. 45T0376649
45 . Año – Mes – Día
2025 – 03 – 15
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
9103329113
52 . Año – Mes – Día
2025 – 03 – 15
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
249
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.114.18
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
855
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.
125.50
72 . Peso neto kgs. dcms.
76.00
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
54.497.56
79 . Valor fletes USD
1.185.98 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
229.103.215
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
229.103.215
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
2.70
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.188.68
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
55.686.24
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: 551098-DECL: 1897339-DO: 893106477251- 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: 3086038937. ID DELIVERY: 6080964021. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A165MZKILTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A16 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, MO(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
032025000682160
133. Feha: 202503 19
134 . Levante No. 032025000433444 135 . Fecha
2025 – 03 – 25
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 92032502201961
Fecha presentación 2025-03-19 19:39:28
Valor pagado $0.00
Fecha de Impresión: 2025-03-25 12:04:14
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000682160-5
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DELO: SM-A165M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A165M/DS,BLACK,LTC( QTY. 400,00 u )(400,00 PCE);
IMEIS: 356927263848420/358318113848422. 356927263848446/358318113848448. 356927263848461/358318113848463. 356927263848487/3583181
13848489. 356927263848495/358318113848497. 356927263848503/358318113848505. 356927263848511/358318113848513.356927263848545/35831
8113848547. 356927263848552/358318113848554. 356927263848578/358318113848570. 356927263848586/358318113848588. 356927263848594/35
8318113848596. 356927263848636/358318113848638. 356927263848651/358318113848653. 356927263848677/358318113848679. 356927263848693
/358318113848695. 356927263848701/358318113848703. 356927263848719/358318113848711. 356927263848727/358318113848729. 356927263848
735/358318113848737. 356927263848743/358318113848745. 356927263848750/358318113848752. 356927263848768/358318113848760. 356927263
848776/358318113848778. 356927263848800/358318113848802. 356927263848818/358318113848810. 35 6927263848826/358318113848828. 35692
7263848834/358318113848836. 356927263848842/358318113848844. 356927263848875/358318113848877. 356927263848909/358318113848901. 35
6927263848933/358318113848935. 356927263848941/358318113848943. 356927263848958/358318113848950. 356927263848974/358318113848976.
356927263849006/358318113849008. 356927263849014/358318113849016. 356927263849022/358318113849024. 356927263849030/3583181138490
32. 356927263849048/358318113849040. 356927263849097/358318113849099. 356927263849139/358318113849131. 356927263849154/3583181138
49156. 356927263849162/358318113849164. 356927263849204/358318113849206. 356927263856134/358318113856136. 356927263856324/3583181
13856326. 356927263856431/358318113856433. 356927263856704/358318113856706. 356927263857413/358318113857415. 356927263857777/3583
18113857779. 356927263858163/358318113858165. 356927263858189/358318113858181. 356927263858213/358318113858215. 356927263859401/3
58318113859403. 356927263859906/358318113859908. 356927263861027/358318113861029. 356927263861084/358318113861086. 35692726386114
2/358318113861144. 356927263861332/358318113861334.356927263861399/358318113861391. 356927263861407/358318113861409. 356927263861
423/358318113861425. 356927263861472/358318113861474. 356927263861506/358318113861508. 356927263861514/358318113861516. 356927263
861910/358318113861912. 356927263862082/358318113862084. 356927263862207/358318113862209. 356927263862231/358318113862233. 356927
263864260/358318113864262. 356927263864278/358318113864270. 356927263864351/358318113864353. 356927263864377/358318113864379. 356
927263864492/358318113864494. 356927263864518/358318113864510. 356927263864526/358318113864528.356927263864559/358318113864551. 3
56927263864567/358318113864569. 356927263865267/358318113865269. 356927263865325/358318113865327. 356927263865440/358318113865442
. 356927263865457/358318113865459. 356927263865549/358318113865541. 356927263865671/358318113865673. 356927263865846/358318113865
848. 356927263865986/358318113865988. 356927263866000/358318113866002. 356927263866042/358318113866044. 356927263866265/358318113
866267. 356927263849212/358318113849214. 356927263849220/358318113849222. 356927263849238/358318113849230. 356927263849246/358318
113849248. 356927263849261/358318113849263. 356927263849287/358318113849289. 356927263849295/358318113849297. 356927263849303/358
318113849305. 356927263849311/358318113849313. 356927263849329/358318113849321. 356927263849337/358318113849339. 356927263849386/
358318113849388. 356927263849394/358318113849396. 356927263849402/358318113849404. 356927263849410/358318113849412. 3569272638494
28/358318113849420. 356927263849436/358318113849438. 356927263849444/358318113849446. 356927263849451/358318113849453. 3569272638
49485/358318113849487. 356927263849493/358318113849495. 356927263849501/358318113849503. 356927263849535/358318113849537. 3569272
63849550/358318113849552. 356927263849568/358318113849560. 356927263849576/358318113849578. 356927263849592/358318113849594. 3569
27263849618/358318113849610. 356927263849626/358318113849628. 356927263849642/358318113849644. 356927263849667/358318113849669. 3
56927263849675/358318113849677. 356927263849691/358318113849693. 356927263849725/358318113849727. 356927263849733/358318113849735
. 356927263849782/358318113849784. 356927263849816/358318113849818. 356927263849824/358318113849826. 356927263849832/358318113849
834. 356927263849873/358318113849875.356927263849881/358318113849883. 356927263849899/358318113849891. 356927263849907/3583181138
49909. 356927263849915/358318113849917. 356927263849923/358318113849925. 356927263852265/358318113852267. 356927263852273/3583181
13852275. 356927263852281/358318113852283. 356927263852307/358318113852309. 356927263852315/358318113852317. 356927263852331/3583
18113852333. 356927263852364/358318113852366. 356927263852372/358318113852374. 356927263852414/358318113852416. 356927263852422/3
58318113852424. 356927263852430/358318113852432. 356927263852455/358318113852457.356927263852463/358318113852465. 356927263852497
/358318113852499. 356927263852521/358318113852523. 356927263852562/358318113852564. 356927263852570/358318113852572. 356927263852
588/358318113852580. 356927263852596/358318113852598. 356927263852612/358318113852614. 356927263852661/358318113852663. 356927263
852729/358318113852721. 356927263852745/358318113852747. 356927263852760/358318113852762. 356927263852802/358318113852804. 356927
263852810/358318113852812. 356927263852836/358318113852838. 356927263852851/358318113852853. 356927263852927/358318113852929. 356
927263852950/358318113852952. 356927263853073/358318113853075. 356927263853172/358318113853174. 356927263853263/358318113853265.
356927263853354/358318113853356. 356927263853487/358318113853489. 356927263853495/358318113853497. 356927263853511/35831811385351
3. 356927263853594/358318113853596. 356927263853636/358318113853638. 356927263853669/358318113853661. 356927263853693/35831811385
3695. 356927263853966/358318113853968. 356927263853974/358318113853976. 356927263854766/358318113854768. 356927263854774/35831811
3854776. 356927263849931/358318113849933. 356927263849949/358318113849941. 356927263849956/358318113849958. 356927263850129/35831
8113850121. 356927263850152/358318113850154. 356927263850194/358318113850196. 356927263850335/358318113850337. 356927263850483/35
8318113850485. 356927263850525/358318113850527. 356927263850582/358318113850584. 356927263850673/358318113850675. 356927263850756
/358318113850758. 356927263850764/358318113850766. 356927263850806/358318113850808. 356927263851010/358318113851012. 356927263851
036/358318113851038. 356927263851051/358318113851053. 356927263851101/358318113851103. 356927263851234/358318113851236. 356927263
851309/358318113851301.356927263851499/358318113851491. 356927263851556/358318113851558. 356927263851598/358318113851590. 3569272
63851622/358318113851624. 356927263851648/358318113851640. 356927263851655/358318113851657. 356927263851747/358318113851749. 3569
27263851770/358318113851772. 356927263851820/358318113851822. 356927263851838/358318113851830. 356927263851853/358318113851855. 3
56927263851861/358318113851863. 356927263851879/358318113851871. 356927263851895/358318113851897. 356927263851929/358318113851921
. 356927263851937/358318113851939. 356927263851945/358318113851947.356927263851986/358318113851988. 356927263851994/3583181138519
96. 356927263852109/358318113852101. 356927263852141/358318113852143. 356927263852174/358318113852176. 356927263852182/3583181138
52184. 356927263852190/358318113852192. 356927263852257/358318113852259. 356927263840278/358318113840270. 356927263840583/3583181
13840585. 356927263841342/358318113841344. 356927263845905/358318113845907. 356927263846218/358318113846210. 356927263846374/3583
18113846376. 356927263846549/358318113846541. 356927263846689/358318113846681. 356927263846879/358318113846871. 356927263846945/3
58318113846947. 356927263846978/358318113846970. 356927263846986/358318113846988. 356927263847026/358318113847028. 35692726384711
7/358318113847119. 356927263847224/358318113847226. 356927263847372/358318113847374. 356927263847406/358318113847408. 35692726384
7430/358318113847432. 356927263847489/358318113847481. 356927263847570/358318113847572. 356927263847596/358318113847598. 35692726
3847620/358318113847622. 356927263847851/358318113847853. 356927263847893/358318113847895. 356927263847943/358318113847945. 35692
7263847950/358318113847952. 356927263847992/358318113847994. 356927263848024/358318113848026. 356927263848032/358318113848034. 35
6927263848057/358318113848059. 356927263848073/358318113848075. 356927263848107/358318113848109. 356927263848123/358318113848125.
356927263848131/358318113848133. 356927263848164/358318113848166. 356927263848255/358318113848257. 356927263848263/3583181138482
65. 356927263848271/358318113848273. 356927263848297/358318113848299. 356927263848305/358318113848307. 356927263848313/3583181138
48315. 356927263848339/358318113848331. 356927263848354/358318113848356. 356927263848388/358318113848380. 356927263848412/3583181
13848414.356927263866273/358318113866275. 356927263866315/358318113866317. 356927263866331/358318113866333. 356927263866398/35831
8113866390. 356927263866414/358318113866416. 356927263866422/358318113866424. 356927263866463/358318113866465. 356927263866471/35
8318113866473. 356927263866745/358318113866747. 356927263866810/358318113866812. 356927263866885/358318113866887. 356927263867131
/358318113867133. 356927263867768/358318113867760. 356927263867776/358318113867778. 356927263867800/358318113867802. 356927263867
826/358318113867828. 356927263867883/358318113867885.356927263868063/358318113868065. 356927263868824/358318113868826. 3569272638
032025000682160-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000682160-5
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
68907/358318113868909. 356927263869251/358318113869253. 356927263869525/358318113869527. 356927263869566/358318113869568. 3569272
63869574/358318113869576. 356927263869582/358318113869584. 356927263869590/358318113869592. 356927263869608/358318113869600. 3569
27263869707/358318113869709. 356927263869749/358318113869741. 356927263869772/358318113869774. 356927263869806/358318113869808. 3
56927263869814/358318113869816. 356927263869830/358318113869832. 356927263869855/358318113869857. 356927263869889/358318113869881
. 356927263869897/358318113869899. 356927263869947/358318113869949. 356927263869988/358318113869980. 356927263869996/358318113869
998. 356927263870028/358318113870020. 356927263870036/358318113870038. 356927263870051/358318113870053. 356927263870069/358318113
870061. 356927263870077/358318113870079. 356927263870085/358318113870087. 356927263870101/358318113870103. 356927263870119/358318
113870111. 356927263870135/358318113870137. 356927263870143/358318113870145. 356927263870168/358318113870160. 356927263870184/358
318113870186. 356927263870234/358318113870236. 356927263870366/358318113870368. 356927263870408/358318113870400. 356927263870416/
358318113870418. 356927263870440/358318113870442. 356927263870507/358318113870509. 356927263870549/358318113870541. 3569272638705
56/358318113870558. 356927263870572/358318113870574. 356927263870614/358318113870616. 356927263870655/358318113870657. 3569272638
70689/358318113870681. 356927263870721/358318113870723. 356927263870747/358318113870749. 356927263870754/358318113870756. 3569272
63870762/358318113870764. 356927263870770/358318113870772. 356927263870788/358318113870780. 356927263870812/358318113870814.35692
7263870820/358318113870822. 356927263870838/358318113870830. 356927263870853/358318113870855. 356927263870879/358318113870871. 35
6927263870911/358318113870913. 356927263870929/358318113870921. 356927263870945/358318113870947. 356927263870952/358318113870954.
356927263870986/358318113870988. 356927263870994/358318113870996. 356927263871000/358318113871002. 356927263871075/3583181138710
77. 356927263871083/358318113871085. 356927263871091/358318113871093. 356927263871141/358318113871143. 356927263871174/3583181138
71176. 356927263871190/358318113871192.356927263871216/358318113871218. 356927263871232/358318113871234. 356927263871240/35831811
3871242. 356927263871257/358318113871259. 356927263871265/358318113871267. 356927263871273/358318113871275. 356927263871299/35831
8113871291. 356927263871315/358318113871317. 356927263871323/358318113871325. 356927263871331/358318113871333. 356927263871372/35
8318113871374. 356927263871398/358318113871390. 356927263871406/358318113871408. 356927263871455/358318113871457. 356927263871463
/358318113871465. 356927263871489/358318113871481. 356927263872099/358318113872091. 356927263872388/358318113872380. 356927263872
529/358318113872521. 356927263872636/358318113872638. 356927263872818/358318113872810. 356927263872966/358318113872968. 356927263
873022/358318113873024. 356927263873048/358318113873040. 356927263873063/358318113873065. 356927263873089/358318113873081. 356927
263873188/358318113873180. 356927263873204/358318113873206. 356927263873212/358318113873214. 356927263873220/358318113873222. 356
927263873279/358318113873271. 356927263873287/358318113873289. 356927263873311/358318113873313. 356927263873402/358318113873404.
356927263873410/358318113873412. 356927263873436/358318113873438. 356927263873444/358318113873446. 356927263873477/35831811387347
9. 356927263873501/358318113873503. 356927263873535/358318113873537. 356927263873568/358318113873560. 356927263873626/35831811387
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032025000682160-5
Espacio para uso exclusivo de la Entidad Recaudadora
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