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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
032025001004424-0
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. 116575015619282
43 . Año – Mes – Día
2025 – 05 – 25
44 . Documento de transporte
No. HKG0417426
45 . Año – Mes – Día
2025 – 05 – 21
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
6900363963
52 . Año – Mes – Día
2025 – 05 – 13
53 . Cod. país
procedencia
351
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.
4.196.66
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.
109.00
72 . Peso neto kgs. dcms.
81.30
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
300.00
78 .Valor FOB
USD
16.462.25
79 . Valor fletes USD
861.10 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
72.702.602
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
72.702.602
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
0.57
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
861.67
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
17.323.92
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: 559056-DECL: 1918468-DO: 893112721251- 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: 3089259651. ID DELIVERY: 6082122430. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZSDLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, 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
032025001004424
133. Feha: 202505 22
134 . Levante No. 032025000831843 135 . Fecha
2025 – 05 – 26
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 92032503986395
Fecha presentación 2025-05-22 20:45:49
Valor pagado $0.00
Fecha de Impresión: 2025-05-26 17:02:11
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001004424-0
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,SILVER,LTC( QTY. 300,00 u )(300,00 PCE);
IMEIS: 351641247720804/351847827720805. 351641247721109/351847827721100. 351641247721224/351847827721225. 351641247721448/351847
827721449. 351641247721646/351847827721647. 351641247721844/351847827721845. 351641247721877/351847827721878. 351641247721927/351
847827721928. 351641247721992/351847827721993. 351641247722008/351847827722009. 351641247722107/351847827722108. 351641247722156/
351847827722157. 351641247722305/351847827722306. 351641247722503/351847827722504. 351641247722560/351847827722561. 3516412477226
77/351847827722678. 351641247722966/351847827722967. 351641247723014/351847827723015. 351641247723352/351847827723353. 3516412477
23402/351847827723403. 351641247723410/351847827723411. 351641247723436/351847827723437. 351641247723451/351847827723452. 3516412
47723493/351847827723494. 351641247723519/351847827723510. 351641247723527/351847827723528. 3 51641247723535/351847827723536. 351
641247723543/351847827723544. 351641247723550/351847827723551. 351641247723568/351847827723569. 351641247723600/351847827723601.
351641247723618/351847827723619. 351641247723642/351847827723643. 351641247723733/351847827723734. 351641247723766/35184782772376
7. 351641247723782/351847827723783. 351641247723899/351847827723890. 351641247723956/351847827723957. 351641247723998/35184782772
3999. 351641247724004/351847827724005. 351641247724012/351847827724013. 351641247724038/351847827724039. 351641247724046/35184782
7724047.351641247724087/351847827724088. 351641247724103/351847827724104. 351641247724129/351847827724120. 351641247724152/351847
827724153. 351641247724160/351847827724161. 351641247724178/351847827724179. 351641247724251/351847827724252. 351641247724343/351
847827724344. 351641247724376/351847827724377. 351641247724566/351847827724567. 351641247724632/351847827724633. 351641247724640/
351847827724641. 351641247724665/351847827724666. 351641247724673/351847827724674. 351641247724723/351847827724724. 3516412477247
49/351847827724740. 351641247724764/351847827724765.351641247724830/351847827724831. 351641247724871/351847827724872. 35164124772
4905/351847827724906. 351641247724947/351847827724948. 351641247725019/351847827725010. 351641247725035/351847827725036. 35164124
7725050/351847827725051. 351641247725076/351847827725077. 351641247725092/351847827725093. 351641247725142/351847827725143. 35164
1247725159/351847827725150. 351641247725175/351847827725176. 351641247725183/351847827725184. 351641247725209/351847827725200. 35
1641247725217/351847827725218. 351641247725225/351847827725226. 351641247725233/351847827725234. 351641247725258/351847827725259.
351641247725274/351847827725275. 351641247725290/351847827725291. 351641247725324/351847827725325. 351641247725555/3518478277255
56. 351641247725563/351847827725564. 351641247725704/351847827725705. 351641247725720/351847827725721. 351641247725753/3518478277
25754. 351641247725787/351847827725788. 351641247725795/351847827725796. 351641247725811/351847827725812. 351641247725829/3518478
27725820. 351641247725837/351847827725838. 351641247725852/351847827725853. 351641247725860/351847827725861. 351641247725878/3518
47827725879. 351641247725886/351847827725887. 351641247725894/351847827725895. 351641247725902/351847827725903. 351641247725910/3
51847827725911. 351641247725928/351847827725929. 351641247725936/351847827725937. 351641247725944/351847827725945. 35164124772595
1/351847827725952. 351641247725969/351847827725960. 351641247725977/351847827725978. 351641247725985/351847827725986. 35164124772
5993/351847827725994. 351641247726009/351847827726000. 351641247726017/351847827726018. 351641247726025/351847827726026. 35164124
7726033/351847827726034. 351641247726041/351847827726042. 351641247726058/351847827726059. 351641247726066/351847827726067.351641
247726074/351847827726075. 351641247726082/351847827726083. 351641247726090/351847827726091. 351641247726108/351847827726109. 351
641247726124/351847827726125. 351641247726132/351847827726133. 351641247726157/351847827726158. 351641247726173/351847827726174.
351641247726181/351847827726182. 351641247726207/351847827726208. 351641247726215/351847827726216. 351641247726223/35184782772622
4. 351641247726249/351847827726240. 351641247726256/351847827726257. 351641247726264/351847827726265. 351641247726272/35184782772
6273. 351641247726280/351847827726281.351641247726298/351847827726299. 351641247726306/351847827726307. 351641247726314/351847827
726315. 351641247726322/351847827726323. 351641247726330/351847827726331. 351641247726348/351847827726349. 351641247726355/351847
827726356. 351641247726363/351847827726364. 351641247726371/351847827726372. 351641247726389/351847827726380. 351641247726397/351
847827726398. 351641247726405/351847827726406. 351641247726413/351847827726414. 351641247726421/351847827726422. 351641247726447/
351847827726448. 351641247726462/351847827726463. 351641247726470/351847827726471. 351641247726488/351847827726489. 3516412477264
96/351847827726497. 351641247726520/351847827726521. 351641247726553/351847827726554. 351641247726561/351847827726562. 3516412477
26587/351847827726588. 351641247726595/351847827726596. 351641247726603/351847827726604. 351641247726611/351847827726612. 3516412
47726629/351847827726620. 351641247726637/351847827726638. 351641247726652/351847827726653. 351641247726660/351847827726661. 3516
41247726686/351847827726687. 351641247726694/351847827726695. 351641247726710/351847827726711. 351641247726744/351847827726745. 3
51641247726751/351847827726752. 351641247726769/351847827726760. 351641247726777/351847827726778. 351641247726785/351847827726786
. 351641247726801/351847827726802. 351641247726819/351847827726810. 351641247726827/351847827726828. 351641247726835/351847827726
836. 351641247726876/351847827726877. 351641247726884/351847827726885. 351641247726934/351847827726935. 351641247726959/351847827
726950. 351641247726967/351847827726968. 351641247726975/351847827726976. 351641247726983/351847827726984. 351641247726991/351847
827726992. 351641247727007/351847827727008. 351641247727015/351847827727016. 351641247727023/351847827727024.351641247727031/3518
47827727032. 351641247727049/351847827727040. 351641247727056/351847827727057. 351641247727064/351847827727065. 351641247727072/3
51847827727073. 351641247727080/351847827727081. 351641247727098/351847827727099. 351641247727106/351847827727107. 35164124772712
2/351847827727123. 351641247727155/351847827727156. 351641247727163/351847827727164. 351641247727171/351847827727172. 35164124772
7189/351847827727180. 351641247727197/351847827727198. 351641247727205/351847827727206. 351641247727213/351847827727214. 35164124
7727239/351847827727230.351641247727395/351847827727396. 351641247727403/351847827727404. 351641247727411/351847827727412. 351641
247727478/351847827727479. 351641247727585/351847827727586. 351641247727593/351847827727594. 351641247727619/351847827727610. 351
641247727635/351847827727636. 351641247727643/351847827727644. 351641247727767/351847827727768. 351641247727775/351847827727776.
351641247727783/351847827727784. 351641247727791/351847827727792. 351641247727817/351847827727818. 351641247727833/35184782772783
4. 351641247727841/351847827727842. 351641247727858/351847827727859. 351641247727866/351847827727867. 351641247727874/35184782772
7875. 351641247727882/351847827727883. 351641247727890/351847827727891. 351641247727908/351847827727909. 351641247727916/35184782
7727917. 351641247727932/351847827727933. 351641247727940/351847827727941. 351641247727957/351847827727958. 351641247727965/35184
7827727966. 351641247727973/351847827727974. 351641247727981/351847827727982. 351641247727999/351847827727990. 351641247728005/35
1847827728006. 351641247728021/351847827728022. 351641247728039/351847827728030. 351641247728054/351847827728055. 351641247728062
/351847827728063. 351641247728070/351847827728071. 351641247728088/351847827728089. 351641247728096/351847827728097. 351641247728
120/351847827728121. 351641247728138/351847827728139. 351641247728146/351847827728147. 351641247728153/351847827728154. 351641247
728161/351847827728162. 351641247728179/351847827728170. 351641247728187/351847827728188. 351641247728195/351847827728196. 351641
247728203/351847827728204. 351641247728211/351847827728212. 351641247728229/351847827728220. 351641247728245/351847827728246. 351
641247728252/351847827728253. 351641247728260/351847827728261. 351641247728278/351847827728279.351641247728286/351847827728287. 3
51641247728294/351847827728295. 351641247728302/351847827728303. 351641247728310/351847827728311. 351641247728328/351847827728329
. 351641247728336/351847827728337. 351641247728369/351847827728360. 351641247728377/351847827728378. 351641247728393/351847827728
394. 351641247728401/351847827728402. 351641247728419/351847827728410. 351641247728427/351847827728428. 351641247728435/351847827
728436. 351641247728443/351847827728444. 351641247728468/351847827728469. 351641247728476/351847827728477. 351641247728484/351847
827728485.351641247728492/351847827728493. 351641247728500/351847827728501. 351641247728526/351847827728527. 351641247728534/3518
47827728535. 351641247728542/351847827728543. 351641247728559/351847827728550. 351641247728567/351847827728568. 351641247728575/3
51847827728576. 351641247728609/351847827728600. 351641247728625/351847827728626. 351641247728641/351847827728642. 35164124772866
6/351847827728667. 351641247728682/351847827728683. 351641247728708/351847827728709. 351641247728765/351847827728766. 35164124772
8781/351847827728782. 351641247728823/351847827728824. 351641247729458/351847827729459. 351641247729466/351847827729467. 35164124
032025001004424-0
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001004424-0
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
7729474/351847827729475. 351641247729490/351847827729491. 351641247729524/351847827729525. 351641247729540/351847827729541. 35164
1247729565/351847827729566. 351641247729573/351847827729574. 351641247729615/351847827729616. 351641247729623/351847827729624. 35
1641247729631/351847827729632. 351641247729649/351847827729640. 351641247729722/351847827729723XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025001004424-0
Espacio para uso exclusivo de la Entidad Recaudadora
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