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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
032025000719447-5
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. 116575015413976
43 . Año – Mes – Día
2025 – 03 – 29
44 . Documento de transporte
No. HKG0403950
45 . Año – Mes – Día
2025 – 03 – 25
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
6900351835
52 . Año – Mes – Día
2025 – 03 – 18
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
244
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.187.72
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.
137.00
72 . Peso neto kgs. dcms.
108.40
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
27.317.46
79 . Valor fletes USD
1.082.30 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
118.935.980
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
118.935.980
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
1.37
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.083.67
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
28.401.13
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: 551910-DECL: 1899311-DO: 893107254251- 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: 3086126512. ID DELIVERY: 6081125619. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZKGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05 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
032025000719447
133. Feha: 202503 27
134 . Levante No. 032025000468891 135 . Fecha
2025 – 03 – 31
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 92032502395658
Fecha presentación 2025-03-27 14:02:42
Valor pagado $0.00
Fecha de Impresión: 2025-03-31 13:15:33
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000719447-5
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,BLACK,LTC( QTY. 400,00 u )(400,00 PCE);
IMEIS: 351641245504754/351847825504755. 351641245504788/351847825504789. 351641245504937/351847825504938. 351641245504945/3518478
25504946. 351641245505017/351847825505018. 351641245505033/351847825505034. 351641245505074/351847825505075.351641245505090/35184
7825505091. 351641245505108/351847825505109. 351641245505132/351847825505133. 351641245505256/351847825505257. 351641245505397/35
1847825505398. 351641245505504/351847825505505. 351641245505553/351847825505554. 351641245505611/351847825505612. 351641245505652
/351847825505653. 351641245505686/351847825505687. 351641245505710/351847825505711. 351641245505728/351847825505729. 351641245505
736/351847825505737. 351641245505744/351847825505745. 351641245505751/351847825505752. 351641245505769/351847825505760. 351641245
505777/351847825505778. 351641245505785/351847825505786. 351641245505793/351847825505794. 35 1641245505801/351847825505802. 35164
1245505819/351847825505810. 351641245505827/351847825505828. 351641245505835/351847825505836. 351641245505843/351847825505844. 35
1641245505850/351847825505851. 351641245505868/351847825505869. 351641245505876/351847825505877. 351641245505884/351847825505885.
351641245505892/351847825505893. 351641245505900/351847825505901. 351641245505918/351847825505919. 351641245505926/3518478255059
27. 351641245505934/351847825505935. 351641245505942/351847825505943. 351641245505959/351847825505950. 351641245505967/3518478255
05968. 351641245505975/351847825505976. 351641245505983/351847825505984. 351641245505991/351847825505992. 351641245506015/3518478
25506016. 351641245506023/351847825506024. 351641245506031/351847825506032. 351641245506056/351847825506057. 351641245506064/3518
47825506065. 351641245506072/351847825506073. 351641245506080/351847825506081. 351641245506106/351847825506107. 351641245506114/3
51847825506115. 351641245506122/351847825506123. 351641245506197/351847825506198. 351641245506205/351847825506206. 35164124550623
9/351847825506230. 351641245506387/351847825506388.351641245506502/351847825506503. 351641245506528/351847825506529. 351641245506
551/351847825506552. 351641245506692/351847825506693. 351641245506742/351847825506743. 351641245506833/351847825506834. 351641245
506957/351847825506958. 351641245507245/351847825507246. 351641245507302/351847825507303. 351641245507310/351847825507311. 351641
245507336/351847825507337. 351641245507344/351847825507345. 351641245507369/351847825507360. 351641245507377/351847825507378. 351
641245507385/351847825507386. 351641245507393/351847825507394. 351641245507401/351847825507402.351641245507419/351847825507410. 3
51641245507435/351847825507436. 351641245507443/351847825507444. 351641245507450/351847825507451. 351641245507476/351847825507477
. 351641245507492/351847825507493. 351641245507500/351847825507501. 351641245507518/351847825507519. 351641245507534/351847825507
535. 351641245507542/351847825507543. 351641245507682/351847825507683. 351641245507773/351847825507774. 351641245507880/351847825
507881. 351641245507971/351847825507972. 351641245508136/351847825508137. 351641245508243/351847825508244. 351641245508276/351847
825508277. 351641245508292/351847825508293. 351641245508300/351847825508301. 351641245508318/351847825508319. 351641245508326/351
847825508327. 351641245508367/351847825508368. 351641245508375/351847825508376. 351641245508417/351847825508418. 351641245508433/
351847825508434. 351641245508441/351847825508442. 351641245508458/351847825508459. 351641245508466/351847825508467. 3516412455084
74/351847825508475. 351641245508482/351847825508483. 351641245508490/351847825508491. 351641245508508/351847825508509. 3516412455
08516/351847825508517. 351641245508524/351847825508525. 351641245508557/351847825508558. 351641245508573/351847825508574. 3516412
45508607/351847825508608. 351641245508615/351847825508616. 351641245508649/351847825508640. 351641245508748/351847825508749. 3516
41245508771/351847825508772. 351641245508813/351847825508814. 351641245509274/351847825509275. 351641245509282/351847825509283. 3
51641245509324/351847825509325. 351641245509415/351847825509416. 351641245509431/351847825509432. 351641245509589/351847825509580
. 351641245509597/351847825509598. 351641245509613/351847825509614. 351641245509639/351847825509630. 351641245509647/351847825509
648. 351641245509654/351847825509655.351641245509662/351847825509663. 351641245509688/351847825509689. 351641245509696/3518478255
09697. 351641245509712/351847825509713. 351641245509720/351847825509721. 351641245509738/351847825509739. 351641245509746/3518478
25509747. 351641245509753/351847825509754. 351641245509761/351847825509762. 351641245509779/351847825509770. 351641245509787/3518
47825509788. 351641245509795/351847825509796. 351641245509803/351847825509804. 351641245509811/351847825509812. 351641245509837/3
51847825509838. 351641245509845/351847825509846. 351641245509852/351847825509853.351641245509894/351847825509895. 351641245509902
/351847825509903. 351641245509910/351847825509911. 351641245509928/351847825509929. 351641245509936/351847825509937. 351641245509
951/351847825509952. 351641245509977/351847825509978. 351641245509985/351847825509986. 351641245509993/351847825509994. 351641245
510009/351847825510000. 351641245510017/351847825510018. 351641245510025/351847825510026. 351641245510033/351847825510034. 351641
245510041/351847825510042. 351641245510058/351847825510059. 351641245510082/351847825510083. 351641245510116/351847825510117. 351
641245510124/351847825510125. 351641245510132/351847825510133. 351641245510140/351847825510141. 351641245510157/351847825510158.
351641245510165/351847825510166. 351641245510173/351847825510174. 351641245510181/351847825510182. 351641245510199/35184782551019
0. 351641245510207/351847825510208. 351641245510223/351847825510224. 351641245510231/351847825510232. 351641245510256/35184782551
0257. 351641245510264/351847825510265. 351641245510272/351847825510273. 351641245510280/351847825510281. 351641245510405/35184782
5510406. 351641245512716/351847825512717. 351641245512732/351847825512733. 351641245512740/351847825512741. 351641245512757/35184
7825512758. 351641245512765/351847825512766. 351641245512773/351847825512774. 351641245512781/351847825512782. 351641245512807/35
1847825512808. 351641245512815/351847825512816. 351641245512831/351847825512832. 351641245512864/351847825512865. 351641245512906
/351847825512907. 351641245512914/351847825512915. 351641245512930/351847825512931. 351641245512948/351847825512949. 351641245512
963/351847825512964. 351641245512997/351847825512998. 351641245513003/351847825513004. 351641245513011/351847825513012. 351641245
513029/351847825513020.351641245513045/351847825513046. 351641245513060/351847825513061. 351641245513078/351847825513079. 3516412
45513086/351847825513087. 351641245513094/351847825513095. 351641245513102/351847825513103. 351641245513128/351847825513129. 3516
41245513136/351847825513137. 351641245513185/351847825513186. 351641245513193/351847825513194. 351641245513201/351847825513202. 3
51641245513219/351847825513210. 351641245513243/351847825513244. 351641245513250/351847825513251. 351641245513276/351847825513277
. 351641245513284/351847825513285. 351641245513300/351847825513301.351641245513326/351847825513327. 351641245513342/3518478255133
43. 351641245513367/351847825513368. 351641245513409/351847825513400. 351641245513458/351847825513459. 351641245513490/3518478255
13491. 351641245513516/351847825513517. 351641245513524/351847825513525. 351641245513540/351847825513541. 351641245513599/3518478
25513590. 351641245513706/351847825513707. 351641245513722/351847825513723. 351641245513730/351847825513731. 351641245513748/3518
47825513749. 351641245513755/351847825513756. 351641245513763/351847825513764. 351641245513797/351847825513798. 351641245513805/3
51847825513806. 351641245513813/351847825513814. 351641245513821/351847825513822. 351641245513839/351847825513830. 35164124551385
4/351847825513855. 351641245513870/351847825513871. 351641245513888/351847825513889. 351641245513912/351847825513913. 35164124551
3920/351847825513921. 351641245513938/351847825513939. 351641245513946/351847825513947. 351641245513961/351847825513962. 35164124
5513979/351847825513970. 351641245514001/351847825514002. 351641245514019/351847825514010. 351641245514027/351847825514028. 35164
1245514035/351847825514036. 351641245514043/351847825514044. 351641245514050/351847825514051. 351641245514084/351847825514085. 35
1641245514092/351847825514093. 351641245514118/351847825514119. 351641245514175/351847825514176. 351641245514183/351847825514184.
351641245514217/351847825514218. 351641245514225/351847825514226. 351641245514233/351847825514234. 351641245514258/3518478255142
59. 351641245514282/351847825514283. 351641245514290/351847825514291. 351641245514324/351847825514325. 351641245514407/3518478255
14408. 351641245514449/351847825514440. 351641245514506/351847825514507. 351641245514662/351847825514663. 351641245514985/3518478
25514986.351641245510413/351847825510414. 351641245510512/351847825510513. 351641245510728/351847825510729. 351641245510777/35184
7825510778. 351641245510827/351847825510828. 351641245510850/351847825510851. 351641245510868/351847825510869. 351641245510884/35
1847825510885. 351641245510900/351847825510901. 351641245510918/351847825510919. 351641245510942/351847825510943. 351641245510959
/351847825510950. 351641245510975/351847825510976. 351641245510983/351847825510984. 351641245510991/351847825510992. 351641245511
007/351847825511008. 351641245511015/351847825511016.351641245511023/351847825511024. 351641245511031/351847825511032. 3516412455
032025000719447-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000719447-5
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
11049/351847825511040. 351641245511056/351847825511057. 351641245511064/351847825511065. 351641245511072/351847825511073. 3516412
45511080/351847825511081. 351641245511098/351847825511099. 351641245511114/351847825511115. 351641245511122/351847825511123. 3516
41245511155/351847825511156. 351641245511163/351847825511164. 351641245511171/351847825511172. 351641245511189/351847825511180. 3
51641245511213/351847825511214. 351641245511221/351847825511222. 351641245511239/351847825511230. 351641245511247/351847825511248
. 351641245511288/351847825511289. 351641245511296/351847825511297. 351641245511304/351847825511305. 351641245511312/351847825511
313. 351641245511346/351847825511347. 351641245511353/351847825511354. 351641245511361/351847825511362. 351641245511379/351847825
511370. 351641245511387/351847825511388. 351641245511403/351847825511404. 351641245515016/351847825515017. 351641245515024/351847
825515025. 351641245515032/351847825515033. 351641245515040/351847825515041. 351641245515057/351847825515058. 351641245515065/351
847825515066. 351641245515073/351847825515074. 351641245515081/351847825515082. 351641245515099/351847825515090. 351641245515107/
351847825515108. 351641245515115/351847825515116. 351641245515123/351847825515124. 351641245515131/351847825515132. 3516412455151
49/351847825515140. 351641245515156/351847825515157. 351641245515172/351847825515173. 351641245515180/351847825515181. 3516412455
15198/351847825515199. 351641245515214/351847825515215. 351641245515222/351847825515223. 351641245515230/351847825515231. 3516412
45515248/351847825515249. 351641245515255/351847825515256. 351641245515263/351847825515264. 351641245515271/351847825515272.35164
1245515289/351847825515280. 351641245515297/351847825515298. 351641245515305/351847825515306. 351641245515321/351847825515322. 35
1641245515339/351847825515330. 351641245515347/351847825515348. 351641245515354/351847825515355. 351641245515362/351847825515363.
351641245515370/351847825515371. 351641245515396/351847825515397. 351641245515404/351847825515405. 351641245515420/3518478255154
21. 351641245515990/351847825515991. 351641245516063/351847825516064. 351641245516089/351847825516080. 351641245511411/3518478255
11412. 351641245511429/351847825511420.351641245511437/351847825511438. 351641245511478/351847825511479. 351641245511494/35184782
5511495. 351641245511502/351847825511503. 351641245511569/351847825511560. 351641245511577/351847825511578. 351641245511619/35184
7825511610. 351641245511627/351847825511628. 351641245511742/351847825511743. 351641245511759/351847825511750. 351641245511767/35
1847825511768. 351641245511783/351847825511784. 351641245511809/351847825511800. 351641245511825/351847825511826. 351641245511833
/351847825511834. 351641245511932/351847825511933. 351641245511965/351847825511966. 351641245511981/351847825511982. 351641245511
999/351847825511990. 351641245512047/351847825512048. 351641245512054/351847825512055. 351641245512070/351847825512071. 351641245
512096/351847825512097. 351641245512203/351847825512204. 351641245512328/351847825512329. 351641245512369/351847825512360. 351641
245512435/351847825512436. 351641245512443/351847825512444. 351641245512450/351847825512451. 351641245512468/351847825512469. 351
641245512476/351847825512477. 351641245512492/351847825512493. 351641245512542/351847825512543. 351641245512559/351847825512550.
351641245512583/351847825512584. 351641245512609/351847825512600. 351641245512625/351847825512626. 351641245512658/35184782551265
9. 351641245512666/351847825512667. 351641245512674/351847825512675. 351641245512682/351847825512683. 351641245512690/35184782551
2691. 351641245512708/351847825512709XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025000719447-5
Espacio para uso exclusivo de la Entidad Recaudadora
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