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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
032025000855844-8
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
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. 116575015497373
43 . Año – Mes – Día
2025 – 04 – 23
44 . Documento de transporte
No. SHAN0387413
45 . Año – Mes – Día
2025 – 04 – 18
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
9103418729
52 . Año – Mes – Día
2025 – 04 – 18
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
580
56 . Cod. Depto
destino
0
57 . Empresa transportadora
DHL AERO EXPRESO S A SUCURSAL COLOMBIA
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
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.
97.50
72 . Peso neto kgs. dcms.
57.00
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
28.879.08
79 . Valor fletes USD
857.93 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
128.764.515
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
128.764.515
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
1.44
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
859.37
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
29.738.45
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: 555317-DECL: 1908616-DO: 893109736251- 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 R
ESOLUCIÓN 5050 DEL 10DE NOVIEMBRE DE 2016. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOMOL
OGACIÓN)// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA
S.A. OEA COD. OE0001. . PEDIDOS: 3087886896. ID DELIVERY: 6081582491. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A165MZKGLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A16 DUOS (CON ACCESORIOSPARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, MODEL(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
032025000855844
133. Feha: 202504 24
134 . Levante No. 032025000674467 135 . Fecha
2025 – 04 – 24
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 92032503171635
Fecha presentación 2025-04-24 13:27:34
Valor pagado $0.00
Fecha de Impresión: 2025-04-24 13:27:39
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000855844-8
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
O: SM-A165M/DS,USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A165M/DS,BLACK,LTC( QTY. 300,00 u )(300,00 PCE); IMEI
S: 352042194304289/356542824304282. 352042194304297/356542824304290. 352042194304339/356542824304332. 352042194304602/35654282430
4605. 352042194305112/356542824305115. 352042194305690/356542824305693. 352042194305716/356542824305719. 352042194305724/35654282
4305727. 352042194305773/356542824305776. 352042194305799/356542824305792. 352042194305864/356542824305867. 352042194305906/35654
2824305909. 352042194305914/356542824305917. 352042194305948/356542824305941. 352042194306086/356542824306089. 352042194306102/35
6542824306105. 352042194306342/356542824306345. 352042194306409/356542824306402. 352042194306466/356542824306469. 352042194306516
/356542824306519. 352042194306573/356542824306576. 352042194306599/356542824306592. 352042194306623/356542824306626. 352042194306
680/356542824306683.352042194307126/356542824307129. 352042194307159/356542824307152. 3520 42194307167/356542824307160. 352042194
307233/356542824307236. 352042194307639/356542824307632. 352042194307738/356542824307731. 352042194308157/356542824308150. 352042
194308207/356542824308200. 352042194308215/356542824308218. 352042194308371/356542824308374. 352042194308421/356542824308424. 352
042194308447/356542824308440. 352042194308454/356542824308457. 352042194308470/356542824308473. 352042194308538/356542824308531.
352042194308678/356542824308671. 352042194308694/356542824308697.352042194308892/356542824308895. 352042194309767/356542824309760
. 352042194310088/356542824310081. 352042194313355/356542824313358. 352042194313991/356542824313994. 352042194314114/356542824314
117. 352042194314148/356542824314141. 352042194314197/356542824314190. 352042194315194/356542824315197. 352042194315574/356542824
315577. 352042194315996/356542824315999. 352042194316002/356542824316005. 352042194316051/356542824316054. 352042194316093/356542
824316096. 352042194316242/356542824316245. 352042194316259/356542824316252. 352042194316309/356542824316302. 352042194316390/356
542824316393. 352042194316457/356542824316450. 352042194316580/356542824316583. 352042194317570/356542824317573. 352042194317588/
356542824317581. 352042194318016/356542824318019. 352042194318446/356542824318449. 352042194318784/356542824318787. 3520421943189
74/356542824318977. 352042194319519/356542824319512. 352042194319527/356542824319520. 352042194319584/356542824319587. 3520421943
19675/356542824319678. 352042194319725/356542824319728. 352042194319782/356542824319785. 352042194319832/356542824319835. 3520421
94319840/356542824319843. 352042194319907/356542824319900. 352042194319998/356542824319991. 352042194320103/356542824320106. 3520
42194320186/356542824320189. 352042194320202/356542824320205. 352042194320277/356542824320270. 352042194320350/356542824320353. 3
52042194320699/356542824320692. 352042194320707/356542824320700. 352042194320723/356542824320726. 352042194320772/356542824320775
. 352042194320798/356542824320791. 352042194320806/356542824320809. 352042194320822/356542824320825. 352042194320848/356542824320
841. 352042194320863/356542824320866. 352042194320913/356542824320916. 352042194320962/356542824320965. 352042194321002/356542824
321005.352042194321044/356542824321047. 352042194321077/356542824321070. 352042194321176/356542824321179. 352042194321192/3565428
24321195. 352042194321200/356542824321203. 352042194321218/356542824321211. 352042194321226/356542824321229. 352042194321242/3565
42824321245. 352042194321309/356542824321302. 352042194321317/356542824321310. 352042194321655/356542824321658. 352042194321739/3
56542824321732. 352042194321788/356542824321781. 352042194321903/356542824321906. 352042194321911/356542824321914. 35204219432199
4/356542824321997. 352042194322091/356542824322094.352042194322174/356542824322177. 352042194322224/356542824322227. 352042194322
232/356542824322235. 352042194322240/356542824322243. 352042194322257/356542824322250. 352042194322265/356542824322268. 352042194
322315/356542824322318. 352042194322380/356542824322383. 352042194322414/356542824322417. 352042194322430/356542824322433. 352042
194322448/356542824322441. 352042194322596/356542824322599. 352042194322687/356542824322680. 352042194322760/356542824322763. 352
042194322810/356542824322813. 352042194322869/356542824322862. 352042194323230/356542824323233. 352042194323578/356542824323571.
352042194323610/356542824323613. 352042194323628/356542824323621. 352042194323644/356542824323647. 352042194323677/35654282432367
0. 352042194341158/356542824341151. 352042194341174/356542824341177. 352042194341240/356542824341243. 352042194341869/35654282434
1862. 352042194342065/356542824342068. 352042194342081/356542824342084. 352042194342255/356542824342258. 352042194342511/35654282
4342514. 352042194343295/356542824343298. 352042194343303/356542824343306. 352042194343345/356542824343348. 352042194343386/35654
2824343389. 352042194343410/356542824343413. 352042194343477/356542824343470. 352042194343576/356542824343579. 352042194343667/35
6542824343660. 352042194343691/356542824343694. 352042194343709/356542824343702. 352042194343717/356542824343710. 352042194343774
/356542824343777. 352042194343840/356542824343843. 352042194343915/356542824343918. 352042194343972/356542824343975. 352042194344
467/356542824344460. 352042194344764/356542824344767. 352042194344822/356542824344825. 352042194345563/356542824345566. 352042194
345753/356542824345756. 352042194346215/356542824346218. 352042194346363/356542824346366. 352042194346439/356542824346432.3520421
94346454/356542824346457. 352042194346520/356542824346523. 352042194346660/356542824346663. 352042194346736/356542824346739. 3520
42194346769/356542824346762. 352042194346785/356542824346788. 352042194346801/356542824346804. 352042194346827/356542824346820. 3
52042194346835/356542824346838. 352042194346850/356542824346853. 352042194346876/356542824346879. 352042194346884/356542824346887
. 352042194347452/356542824347455. 352042194347668/356542824347661. 352042194347692/356542824347695. 352042194347775/356542824347
778. 352042194347940/356542824347943.352042194347965/356542824347968. 352042194347973/356542824347976. 352042194348211/3565428243
48214. 352042194348351/356542824348354. 352042194348500/356542824348503. 352042194348559/356542824348552. 352042194348583/3565428
24348586. 352042194348617/356542824348610. 352042194348625/356542824348628. 352042194348641/356542824348644. 352042194348658/3565
42824348651. 352042194348807/356542824348800. 352042194348856/356542824348859. 352042194348872/356542824348875. 352042194348898/3
56542824348891. 352042194348922/356542824348925. 352042194348948/356542824348941. 352042194349045/356542824349048. 35204219434923
5/356542824349238. 352042194349490/356542824349493. 352042194349565/356542824349568. 352042194349581/356542824349584. 35204219434
9821/356542824349824. 352042194349847/356542824349840. 352042194349854/356542824349857. 352042194351058/356542824351051. 35204219
4351173/356542824351176. 352042194351231/356542824351234. 352042194351256/356542824351259. 352042194351264/356542824351267. 35204
2194310252/356542824310255. 352042194310401/356542824310404. 352042194310443/356542824310446. 352042194310500/356542824310503. 35
2042194310518/356542824310511. 352042194310526/356542824310529. 352042194310625/356542824310628. 352042194310765/356542824310768.
352042194310963/356542824310966. 352042194310989/356542824310982. 352042194311003/356542824311006. 352042194311045/3565428243110
48. 352042194311060/356542824311063. 352042194311102/356542824311105. 352042194311128/356542824311121. 352042194311540/3565428243
11543. 352042194311573/356542824311576. 352042194311623/356542824311626. 352042194311631/356542824311634. 352042194311649/3565428
24311642. 352042194311656/356542824311659. 352042194311714/356542824311717. 352042194311730/356542824311733.352042194311771/35654
2824311774. 352042194311797/356542824311790. 352042194311870/356542824311873. 352042194311961/356542824311964. 352042194311987/35
6542824311980. 352042194312225/356542824312228. 352042194312399/356542824312392. 352042194312498/356542824312491. 352042194312605
/356542824312608. 352042194312621/356542824312624. 352042194312639/356542824312632. 352042194312654/356542824312657. 352042194312
696/356542824312699. 352042194312712/356542824312715. 352042194313074/356542824313077. 352042194313108/356542824313101. 352042194
313165/356542824313168.352042194313173/356542824313176. 352042194313223/356542824313226. 352042194313231/356542824313234. 3520421
94313249/356542824313242. 352042194313256/356542824313259. 352042194323743/356542824323746. 352042194323818/356542824323811. 3520
42194323834/356542824323837. 352042194323883/356542824323886. 352042194323891/356542824323894. 352042194323982/356542824323985. 3
52042194324006/356542824324009. 352042194324022/356542824324025. 352042194324055/356542824324058. 352042194324063/356542824324066
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280. 352042194324303/356542824324306. 352042194324345/356542824324348. 352042194324352/356542824324355. 352042194324386/356542824
324389. 352042194324410/356542824324413. 352042194324444/356542824324447. 352042194324485/356542824324488. 352042194324519/356542
824324512. 352042194324535/356542824324538. 352042194324568/356542824324561. 352042194324576/356542824324579. 352042194324600/356
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356542824339965. 352042194340119/356542824340112. 352042194340176/356542824340179. 352042194340200/356542824340203. 3520421943402
032025000855844-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000855844-8
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
26/356542824340229. 352042194340457/356542824340450. 352042194340614/356542824340617. 352042194340630/356542824340633. 3520421943
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032025000855844-8
Espacio para uso exclusivo de la Entidad Recaudadora
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