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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
032025000858936-0
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. 116575015510104
43 . Año – Mes – Día
2025 – 04 – 26
44 . Documento de transporte
No. 41N0697795
45 . Año – Mes – Día
2025 – 04 – 23
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
6900358185
52 . Año – Mes – Día
2025 – 04 – 17
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.
4.329.90
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.
156.00
72 . Peso neto kgs. dcms.
129.25
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
470.00
78 .Valor FOB
USD
28.977.65
79 . Valor fletes USD
1.131.00 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
130.373.765
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
130.373.765
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
1.46
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.132.46
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
30.110.11
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: 555458-DECL: 1909019-DO: 893110166251- 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: 3087435734. ID DELIVERY: 6081659932. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A065MLGGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A06 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE 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
032025000858936
133. Feha: 202504 24
134 . Levante No. 032025000690350 135 . Fecha
2025 – 04 – 28
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 92032503190106
Fecha presentación 2025-04-24 18:36:36
Valor pagado $0.00
Fecha de Impresión: 2025-04-28 14:58:59
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000858936-0
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 GREEN,LTC( QTY. 470,00 u )(4
70,00 PCE); IMEIS: 350437733009245/350933493009243. 350437733009252/350933493009250. 350437733009260/350933493009268. 35043773300
9278/350933493009276. 350437733009286/350933493009284. 350437733009294/350933493009292. 350437733009302/350933493009300. 35043773
3009310/350933493009318. 350437733009328/350933493009326. 350437733009336/350933493009334. 350437733009344/350933493009342. 35043
7733009351/350933493009359. 350437733009369/350933493009367.350437733009377/350933493009375. 350437733009385/350933493009383. 350
437733009393/350933493009391. 350437733009419/350933493009417. 350437733009427/350933493009425. 350437733009435/350933493009433.
350437733009443/350933493009441. 350437733009450/350933493009458. 350437733009476/350933493009474. 350437733009492/35093349300949
0. 350437733009500/350933493009508. 350437733009518/350933493009516. 350437733009526/3509334 93009524. 350437733009534/3509334930
09532. 350437733009542/350933493009540. 350437733009559/350933493009557. 350437733009567/350933493009565. 350437733009575/3509334
93009573. 350437733009583/350933493009581. 350437733009591/350933493009599. 350437733009633/350933493009631. 350437733009674/3509
33493009672. 350437733009690/350933493009698. 350437733009716/350933493009714. 350437733009724/350933493009722. 350437733009757/3
50933493009755. 350437733009781/350933493009789. 350437733009807/350933493009805. 350437733009815/350933493009813. 35043773300983
1/350933493009839. 350437733009849/350933493009847. 350437733009856/350933493009854. 350437733009864/350933493009862. 35043773300
9880/350933493009888. 350437733009898/350933493009896. 350437733009906/350933493009904. 350437733009914/350933493009912. 35043773
3009930/350933493009938. 350437733009948/350933493009946. 350437733009955/350933493009953. 350437733009963/350933493009961. 35043
7733009971/350933493009979. 350437733010003/350933493010001. 350437733010011/350933493010019. 350437733010029/350933493010027. 35
0437733010037/350933493010035. 350437733010052/350933493010050. 350437733010078/350933493010076. 350437733010102/350933493010100.
350437733010110/350933493010118. 350437733010128/350933493010126. 350437733010136/350933493010134. 350437733010185/3509334930101
83.350437733010193/350933493010191. 350437733010201/350933493010209. 350437733010219/350933493010217. 350437733010235/35093349301
0233. 350437733010250/350933493010258. 350437733010268/350933493010266. 350437733010276/350933493010274. 350437733010284/35093349
3010282. 350437733010292/350933493010290. 350437733010300/350933493010308. 350437733010318/350933493010316. 350437733010326/35093
3493010324. 350437733010334/350933493010332. 350437733010342/350933493010340. 350437733010383/350933493010381. 350437733010391/35
0933493010399. 350437733010409/350933493010407.350437733010417/350933493010415. 350437733010425/350933493010423. 350437733010433/
350933493010431. 350437733010441/350933493010449. 350437733010458/350933493010456. 350437733010466/350933493010464. 3504377330104
82/350933493010480. 350437733010490/350933493010498. 350437733010516/350933493010514. 350437733010524/350933493010522. 3504377330
10532/350933493010530. 350437733010540/350933493010548. 350437733010565/350933493010563. 350437733010573/350933493010571. 3504377
33010599/350933493010597. 350437733010607/350933493010605. 350437733010649/350933493010647. 350437733010672/350933493010670. 3504
37733010706/350933493010704. 350437733010714/350933493010712. 350437733010789/350933493010787. 350437733010797/350933493010795. 3
50437733010813/350933493010811. 350437733010896/350933493010894. 350437733010946/350933493010944. 350437733011019/350933493011017
. 350437733011027/350933493011025. 350437733011068/350933493011066. 350437733011092/350933493011090. 350437733011126/350933493011
124. 350437733011167/350933493011165. 350437733011183/350933493011181. 350437733011217/350933493011215. 350437733011233/350933493
011231. 350437733011241/350933493011249. 350437733011266/350933493011264. 350437733011274/350933493011272. 350437733011290/350933
493011298. 350437733011308/350933493011306. 350437733011316/350933493011314. 350437733011324/350933493011322. 350437733011332/350
933493011330. 350437733011340/350933493011348. 350437733011357/350933493011355. 350437733011365/350933493011363. 350437733011373/
350933493011371. 350437733011381/350933493011389. 350437733011399/350933493011397. 350437733011407/350933493011405. 3504377330114
23/350933493011421. 350437733011431/350933493011439. 350437733011449/350933493011447. 350437733011464/350933493011462.35043773301
1530/350933493011538. 350437733011555/350933493011553. 350437733011571/350933493011579. 350437733011605/350933493011603. 35043773
3011647/350933493011645. 350437733011662/350933493011660. 350437733011720/350933493011728. 350437733011795/350933493011793. 35043
7733011837/350933493011835. 350437733011902/350933493011900. 350437733011951/350933493011959. 350437733012025/350933493012023. 35
0437733012090/350933493012098. 350437733012124/350933493012122. 350437733012181/350933493012189. 350437733012249/350933493012247.
350437733012256/350933493012254.350437733012272/350933493012270. 350437733012314/350933493012312. 350437733012322/35093349301232
0. 350437733012330/350933493012338. 350437733012348/350933493012346. 350437733012355/350933493012353. 350437733012363/35093349301
2361. 350437733012371/350933493012379. 350437733012389/350933493012387. 350437733012397/350933493012395. 350437733012413/35093349
3012411. 350437733012439/350933493012437. 350437733012454/350933493012452. 350437733012462/350933493012460. 350437733012512/35093
3493012510. 350437733012538/350933493012536. 350437733012801/350933493012809. 350437733012819/350933493012817. 350437733012827/35
0933493012825. 350437733012876/350933493012874. 350437733012926/350933493012924. 350437733012942/350933493012940. 350437733012991
/350933493012999. 350437733013023/350933493013021. 350437733013072/350933493013070. 350437733013106/350933493013104. 350437733013
122/350933493013120. 350437733013148/350933493013146. 350437733013197/350933493013195. 350437733013221/350933493013229. 350437733
013296/350933493013294. 350437733013361/350933493013369. 350437733013387/350933493013385. 350437733013429/350933493013427. 350437
733013569/350933493013567. 350437733013619/350933493013617. 350437733013759/350933493013757. 350437733013791/350933493013799. 350
437733013866/350933493013864. 350437733013973/350933493013971. 350437733014047/350933493014045. 350437733014070/350933493014078.
350437733014112/350933493014110. 350437733014229/350933493014227. 350437733014310/350933493014318. 350437733014492/35093349301449
0. 350437733015168/350933493015166. 350437733004600/350933493004608. 350437733004626/350933493004624. 350437733004824/35093349300
4822. 350437733004881/350933493004889. 350437733004972/350933493004970. 350437733004980/350933493004988.350437733005078/350933493
005076. 350437733005102/350933493005100. 350437733005391/350933493005399. 350437733005490/350933493005498. 350437733005508/350933
493005506. 350437733005565/350933493005563. 350437733005573/350933493005571. 350437733005615/350933493005613. 350437733005623/350
933493005621. 350437733005631/350933493005639. 350437733005649/350933493005647. 350437733005656/350933493005654. 350437733005664/
350933493005662. 350437733005680/350933493005688. 350437733005698/350933493005696. 350437733005706/350933493005704. 3504377330057
14/350933493005712.350437733005722/350933493005720. 350437733005730/350933493005738. 350437733005748/350933493005746. 35043773300
5755/350933493005753. 350437733005763/350933493005761. 350437733005771/350933493005779. 350437733005789/350933493005787. 35043773
3005797/350933493005795. 350437733005805/350933493005803. 350437733005821/350933493005829. 350437733005847/350933493005845. 35043
7733005862/350933493005860. 350437733005896/350933493005894. 350437733005912/350933493005910. 350437733005920/350933493005928. 35
0437733005938/350933493005936. 350437733005946/350933493005944. 350437733005953/350933493005951. 350437733005961/350933493005969.
350437733005987/350933493005985. 350437733005995/350933493005993. 350437733006001/350933493006009. 350437733006621/3509334930066
29. 350437733006654/350933493006652. 350437733006662/350933493006660. 350437733006670/350933493006678. 350437733006696/3509334930
06694. 350437733006712/350933493006710. 350437733006720/350933493006728. 350437733006738/350933493006736. 350437733006746/3509334
93006744. 350437733006761/350933493006769. 350437733006787/350933493006785. 350437733006795/350933493006793. 350437733006803/3509
33493006801. 350437733006811/350933493006819. 350437733006829/350933493006827. 350437733006837/350933493006835. 350437733006845/3
50933493006843. 350437733006852/350933493006850. 350437733006860/350933493006868. 350437733006878/350933493006876. 35043773300688
6/350933493006884. 350437733006894/350933493006892. 350437733006902/350933493006900. 350437733006910/350933493006918. 35043773300
6928/350933493006926. 350437733006936/350933493006934. 350437733006951/350933493006959. 350437733006977/350933493006975. 35043773
3006993/350933493006991. 350437733007009/350933493007007. 350437733007017/350933493007015.350437733007033/350933493007031. 350437
733007058/350933493007056. 350437733007082/350933493007080. 350437733007157/350933493007155. 350437733007173/350933493007171. 350
437733007181/350933493007189. 350437733007223/350933493007221. 350437733007249/350933493007247. 350437733007256/350933493007254.
350437733007272/350933493007270. 350437733007280/350933493007288. 350437733007298/350933493007296. 350437733007306/35093349300730
032025000858936-0
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000858936-0
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
4. 350437733007314/350933493007312. 350437733006019/350933493006017. 350437733006027/350933493006025. 350437733006035/35093349300
6033.350437733006043/350933493006041. 350437733006050/350933493006058. 350437733006076/350933493006074. 350437733006084/350933493
006082. 350437733006092/350933493006090. 350437733006100/350933493006108. 350437733006118/350933493006116. 350437733006134/350933
493006132. 350437733006159/350933493006157. 350437733006167/350933493006165. 350437733006175/350933493006173. 350437733006191/350
933493006199. 350437733006217/350933493006215. 350437733006225/350933493006223. 350437733006233/350933493006231. 350437733006241/
350933493006249. 350437733006266/350933493006264. 350437733006282/350933493006280. 350437733006316/350933493006314. 3504377330063
32/350933493006330. 350437733006340/350933493006348. 350437733006357/350933493006355. 350437733006373/350933493006371. 3504377330
06399/350933493006397. 350437733006407/350933493006405. 350437733006423/350933493006421. 350437733006449/350933493006447. 3504377
33006464/350933493006462. 350437733006472/350933493006470. 350437733006480/350933493006488. 350437733006506/350933493006504. 3504
37733006514/350933493006512. 350437733006522/350933493006520. 350437733006530/350933493006538. 350437733006548/350933493006546. 3
50437733006555/350933493006553. 350437733006563/350933493006561. 350437733006571/350933493006579. 350437733006589/350933493006587
. 350437733006597/350933493006595. 350437733006605/350933493006603. 350437733006613/350933493006611. 350437733007322/350933493007
320. 350437733007330/350933493007338. 350437733007348/350933493007346. 350437733007355/350933493007353. 350437733007389/350933493
007387. 350437733007397/350933493007395. 350437733007405/350933493007403. 350437733007421/350933493007429. 350437733007439/350933
493007437. 350437733007447/350933493007445. 350437733007454/350933493007452.350437733007488/350933493007486. 350437733007496/3509
33493007494. 350437733007504/350933493007502. 350437733007512/350933493007510. 350437733007546/350933493007544. 350437733007553/3
50933493007551. 350437733007561/350933493007569. 350437733007579/350933493007577. 350437733007595/350933493007593. 35043773300760
3/350933493007601. 350437733007611/350933493007619. 350437733007637/350933493007635. 350437733007645/350933493007643. 35043773300
7652/350933493007650. 350437733007678/350933493007676. 350437733007694/350933493007692. 350437733007710/350933493007718.350437733
007728/350933493007726. 350437733007736/350933493007734. 350437733007744/350933493007742. 350437733007785/350933493007783. 350437
733007793/350933493007791. 350437733007801/350933493007809. 350437733007827/350933493007825. 350437733007843/350933493007841. 350
437733007850/350933493007858. 350437733007868/350933493007866. 350437733007876/350933493007874. 350437733007884/350933493007882.
350437733007892/350933493007890. 350437733007926/350933493007924. 350437733007934/350933493007932. 350437733007942/35093349300794
0. 350437733007967/350933493007965. 350437733008015/350933493008013. 350437733008023/350933493008021. 350437733008031/35093349300
8039. 350437733008064/350933493008062. 350437733008072/350933493008070. 350437733008080/350933493008088. 350437733008098/35093349
3008096. 350437733008114/350933493008112. 350437733008122/350933493008120. 350437733008148/350933493008146. 350437733008155/35093
3493008153. 350437733008171/350933493008179. 350437733008189/350933493008187. 350437733008197/350933493008195. 350437733008213/35
0933493008211. 350437733008221/350933493008229. 350437733008239/350933493008237. 350437733008247/350933493008245. 350437733008254
/350933493008252. 350437733008262/350933493008260. 350437733008270/350933493008278. 350437733008288/350933493008286. 350437733008
296/350933493008294. 350437733008304/350933493008302. 350437733008312/350933493008310. 350437733008338/350933493008336. 350437733
008346/350933493008344. 350437733008353/350933493008351. 350437733008361/350933493008369. 350437733008379/350933493008377. 350437
733008387/350933493008385. 350437733008395/350933493008393. 350437733008403/350933493008401. 350437733008429/350933493008427. 350
437733008437/350933493008435. 350437733008445/350933493008443.350437733008452/350933493008450. 350437733008460/350933493008468. 3
50437733008478/350933493008476. 350437733008502/350933493008500. 350437733008510/350933493008518. 350437733008528/350933493008526
. 350437733008536/350933493008534. 350437733008544/350933493008542. 350437733008551/350933493008559. 350437733008569/350933493008
567. 350437733008577/350933493008575. 350437733008585/350933493008583. 350437733008593/350933493008591. 350437733008619/350933493
008617. 350437733008627/350933493008625. 350437733008643/350933493008641. 350437733008650/350933493008658.350437733008684/3509334
93008682. 350437733008759/350933493008757. 350437733008767/350933493008765. 350437733008775/350933493008773. 350437733008783/3509
33493008781. 350437733008825/350933493008823. 350437733008874/350933493008872. 350437733008882/350933493008880. 350437733008890/3
50933493008898. 350437733008908/350933493008906. 350437733008916/350933493008914. 350437733008924/350933493008922. 35043773300893
2/350933493008930. 350437733008940/350933493008948. 350437733008965/350933493008963. 350437733008973/350933493008971. 35043773300
8999/350933493008997. 350437733009013/350933493009011. 350437733009021/350933493009029. 350437733009039/350933493009037. 35043773
3009047/350933493009045. 350437733009054/350933493009052. 350437733009062/350933493009060. 350437733009088/350933493009086. 35043
7733009096/350933493009094. 350437733009112/350933493009110. 350437733009120/350933493009128. 350437733009138/350933493009136. 35
0437733009146/350933493009144. 350437733009153/350933493009151. 350437733009161/350933493009169. 350437733009179/350933493009177.
350437733009187/350933493009185. 350437733009195/350933493009193. 350437733009203/350933493009201. 350437733009229/3509334930092
27. 350437733009237/350933493009235XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025000858936-0
Espacio para uso exclusivo de la Entidad Recaudadora
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