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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
032025001155822-6
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. 116575015711763
43 . Año – Mes – Día
2025 – 06 – 20
44 . Documento de transporte
No. PVG71568243
45 . Año – Mes – Día
2025 – 06 – 12
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
6900370332
52 . Año – Mes – Día
2025 – 06 – 09
53 . Cod. país
procedencia
215
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.
4.169.13
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.
128.00
72 . Peso neto kgs. dcms.
101.75
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
370.00
78 .Valor FOB
USD
23.660.80
79 . Valor fletes USD
956.16 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
102.634.683
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
102.634.683
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
0.81
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
956.97
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
24.617.77
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: 562078-DECL: 1926229-DO: 893114893251- 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: 3091073775. ID DELIVERY: 6082592366. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A065MLBGLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A06 DUOS (CON ACCESORIOSPARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL CLARO, (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
032025001155822
133. Feha: 202506 16
134 . Levante No. 032025000962312 135 . Fecha
2025 – 06 – 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 92032504629852
Fecha presentación 2025-06-16 18:12:22
Valor pagado $0.00
Fecha de Impresión: 2025-06-24 13:55:44
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001155822-6
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MODELO: SM-A065M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A065M/DS,LIGHT BLUE,LTC( QTY. 370,00 u )(370,00
PCE); IMEIS: 350437736727348/350933496727346. 350437736727355/350933496727353. 350437736727363/350933496727361. 350437736727371/
350933496727379. 350437736727389/350933496727387. 350437736727397/350933496727395. 350437736727405/350933496727403. 3504377367274
13/350933496727411. 350437736727421/350933496727429. 350437736727439/350933496727437. 350437736727447/350933496727445.35043773672
7454/350933496727452. 350437736727462/350933496727460. 350437736727470/350933496727478. 350437736727488/350933496727486. 35043773
6727496/350933496727494. 350437736727504/350933496727502. 350437736727512/350933496727510. 350437736727520/350933496727528. 35043
7736727538/350933496727536. 350437736727546/350933496727544. 350437736727553/350933496727551. 350437736727561/350933496727569. 35
0437736727579/350933496727577. 350437736727587/350933496727585. 350437736727595/35093349672 7593. 350437736727603/350933496727601
. 350437736727611/350933496727619. 350437736727629/350933496727627. 350437736727637/350933496727635. 350437736727645/350933496727
643. 350437736727652/350933496727650. 350437736727660/350933496727668. 350437736727678/350933496727676. 350437736727686/350933496
727684. 350437736727694/350933496727692. 350437736727702/350933496727700. 350437736727710/350933496727718. 350437736727728/350933
496727726. 350437736727736/350933496727734. 350437736727744/350933496727742. 350437736727751/350933496727759. 350437736727769/350
933496727767. 350437736727777/350933496727775. 350437736727785/350933496727783. 350437736727793/350933496727791. 350437736727801/
350933496727809. 350437736727819/350933496727817. 350437736727827/350933496727825. 350437736727835/350933496727833. 3504377367278
43/350933496727841. 350437736727850/350933496727858. 350437736727868/350933496727866. 350437736727876/350933496727874. 3504377367
27884/350933496727882. 350437736727892/350933496727890. 350437736727900/350933496727908. 350437736727918/350933496727916. 3504377
36727926/350933496727924. 350437736727934/350933496727932. 350437736727942/350933496727940. 350437736727959/350933496727957. 3504
37736727967/350933496727965. 350437736727975/350933496727973.350437736727983/350933496727981. 350437736727991/350933496727999. 35
0437736728007/350933496728005. 350437736728015/350933496728013. 350437736728023/350933496728021. 350437736728031/350933496728039.
350437736728049/350933496728047. 350437736728056/350933496728054. 350437736728064/350933496728062. 350437736728072/3509334967280
70. 350437736728080/350933496728088. 350437736728098/350933496728096. 350437736728106/350933496728104. 350437736728114/3509334967
28112. 350437736728122/350933496728120. 350437736728130/350933496728138. 350437736728148/350933496728146.350437736728155/35093349
6728153. 350437736728163/350933496728161. 350437736728171/350933496728179. 350437736728189/350933496728187. 350437736728197/35093
3496728195. 350437736728205/350933496728203. 350437736728213/350933496728211. 350437736728221/350933496728229. 350437736728239/35
0933496728237. 350437736728247/350933496728245. 350437736728254/350933496728252. 350437736728262/350933496728260. 350437736728270
/350933496728278. 350437736728288/350933496728286. 350437736728296/350933496728294. 350437736728304/350933496728302. 350437736728
312/350933496728310. 350437736728320/350933496728328. 350437736728338/350933496728336. 350437736728346/350933496728344. 350437736
728353/350933496728351. 350437736728361/350933496728369. 350437736728379/350933496728377. 350437736728387/350933496728385. 350437
736728395/350933496728393. 350437736728403/350933496728401. 350437736728411/350933496728419. 350437736728429/350933496728427. 350
437736728437/350933496728435. 350437736728445/350933496728443. 350437736728452/350933496728450. 350437736728460/350933496728468.
350437736728478/350933496728476. 350437736728486/350933496728484. 350437736728494/350933496728492. 350437736728502/35093349672850
0. 350437736728510/350933496728518. 350437736728528/350933496728526. 350437736728536/350933496728534. 350437736728544/35093349672
8542. 350437736728551/350933496728559. 350437736728569/350933496728567. 350437736728577/350933496728575. 350437736728585/35093349
6728583. 350437736728593/350933496728591. 350437736728601/350933496728609. 350437736728619/350933496728617. 350437736728627/35093
3496728625. 350437736728635/350933496728633. 350437736728643/350933496728641. 350437736728650/350933496728658. 350437736728668/35
0933496728666. 350437736728676/350933496728674.350437736728684/350933496728682. 350437736728692/350933496728690. 350437736728700/
350933496728708. 350437736728718/350933496728716. 350437736728726/350933496728724. 350437736728734/350933496728732. 3504377367287
42/350933496728740. 350437736728759/350933496728757. 350437736728767/350933496728765. 350437736728775/350933496728773. 3504377367
28783/350933496728781. 350437736728791/350933496728799. 350437736728809/350933496728807. 350437736728817/350933496728815. 3504377
36728825/350933496728823. 350437736728833/350933496728831. 350437736728841/350933496728849.350437736728858/350933496728856. 35043
7736728866/350933496728864. 350437736728874/350933496728872. 350437736728882/350933496728880. 350437736728890/350933496728898. 35
0437736728908/350933496728906. 350437736728916/350933496728914. 350437736728924/350933496728922. 350437736728932/350933496728930.
350437736728940/350933496728948. 350437736728957/350933496728955. 350437736728965/350933496728963. 350437736728973/3509334967289
71. 350437736728981/350933496728989. 350437736728999/350933496728997. 350437736729005/350933496729003. 350437736729013/3509334967
29011. 350437736729021/350933496729029. 350437736729039/350933496729037. 350437736729047/350933496729045. 350437736729054/3509334
96729052. 350437736729062/350933496729060. 350437736729070/350933496729078. 350437736729088/350933496729086. 350437736729096/3509
33496729094. 350437736729104/350933496729102. 350437736729112/350933496729110. 350437736729120/350933496729128. 350437736729138/3
50933496729136. 350437736729146/350933496729144. 350437736729153/350933496729151. 350437736729161/350933496729169. 35043773672917
9/350933496729177. 350437736729187/350933496729185. 350437736729195/350933496729193. 350437736729203/350933496729201. 35043773672
9211/350933496729219. 350437736729229/350933496729227. 350437736729237/350933496729235. 350437736729245/350933496729243. 35043773
6729252/350933496729250. 350437736729260/350933496729268. 350437736729278/350933496729276. 350437736729286/350933496729284. 35043
7736729294/350933496729292. 350437736729302/350933496729300. 350437736729310/350933496729318. 350437736729328/350933496729326. 35
0437736729336/350933496729334. 350437736729344/350933496729342. 350437736729351/350933496729359. 350437736729369/350933496729367.
350437736729377/350933496729375.350437736729385/350933496729383. 350437736729393/350933496729391. 350437736729401/35093349672940
9. 350437736729419/350933496729417. 350437736729427/350933496729425. 350437736729435/350933496729433. 350437736729443/35093349672
9441. 350437736729450/350933496729458. 350437736729468/350933496729466. 350437736729476/350933496729474. 350437736729484/35093349
6729482. 350437736729492/350933496729490. 350437736729500/350933496729508. 350437736729518/350933496729516. 350437736729526/35093
3496729524. 350437736729534/350933496729532. 350437736729542/350933496729540.350437736729559/350933496729557. 350437736729567/350
933496729565. 350437736729575/350933496729573. 350437736729583/350933496729581. 350437736729591/350933496729599. 350437736729609/
350933496729607. 350437736729617/350933496729615. 350437736729625/350933496729623. 350437736729633/350933496729631. 3504377367296
41/350933496729649. 350437736729658/350933496729656. 350437736729666/350933496729664. 350437736729674/350933496729672. 3504377367
29682/350933496729680. 350437736729690/350933496729698. 350437736729708/350933496729706. 350437736729716/350933496729714. 3504377
36729724/350933496729722. 350437736729732/350933496729730. 350437736729740/350933496729748. 350437736729757/350933496729755. 3504
37736729765/350933496729763. 350437736729773/350933496729771. 350437736729781/350933496729789. 350437736729799/350933496729797. 3
50437736729807/350933496729805. 350437736729815/350933496729813. 350437736729823/350933496729821. 350437736729831/350933496729839
. 350437736729849/350933496729847. 350437736729856/350933496729854. 350437736729864/350933496729862. 350437736729872/350933496729
870. 350437736729880/350933496729888. 350437736729898/350933496729896. 350437736729906/350933496729904. 350437736729914/350933496
729912. 350437736729922/350933496729920. 350437736729930/350933496729938. 350437736729948/350933496729946. 350437736729955/350933
496729953. 350437736729963/350933496729961. 350437736729971/350933496729979. 350437736729989/350933496729987. 350437736729997/350
933496729995. 350437736730003/350933496730001. 350437736730011/350933496730019. 350437736730029/350933496730027. 350437736730037/
350933496730035. 350437736730045/350933496730043. 350437736730052/350933496730050. 350437736730060/350933496730068. 3504377367300
78/350933496730076.350437736730086/350933496730084. 350437736730094/350933496730092. 350437736730102/350933496730100. 35043773673
0110/350933496730118. 350437736730128/350933496730126. 350437736730136/350933496730134. 350437736730144/350933496730142. 35043773
6730151/350933496730159. 350437736730169/350933496730167. 350437736730177/350933496730175. 350437736730185/350933496730183. 35043
7736730193/350933496730191. 350437736730201/350933496730209. 350437736730219/350933496730217. 350437736730227/350933496730225. 35
032025001155822-6
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001155822-6
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
0437736730235/350933496730233. 350437736730243/350933496730241.350437736730250/350933496730258. 350437736730268/350933496730266.
350437736730276/350933496730274. 350437736730284/350933496730282. 350437736730292/350933496730290. 350437736730300/35093349673030
8. 350437736730318/350933496730316. 350437736730326/350933496730324. 350437736730334/350933496730332. 350437736730342/35093349673
0340. 350437736730359/350933496730357. 350437736730367/350933496730365. 350437736730375/350933496730373. 350437736730383/35093349
6730381. 350437736730391/350933496730399. 350437736730409/350933496730407. 350437736730417/350933496730415. 350437736730425/35093
3496730423. 350437736730433/350933496730431. 350437736730441/350933496730449. 350437736730458/350933496730456. 350437736730466/35
0933496730464. 350437736730474/350933496730472. 350437736730482/350933496730480. 350437736730490/350933496730498. 350437736730508
/350933496730506. 350437736730516/350933496730514. 350437736730524/350933496730522. 350437736730532/350933496730530. 350437736730
540/350933496730548. 350437736730557/350933496730555. 350437736730565/350933496730563. 350437736730573/350933496730571. 350437736
730581/350933496730589. 350437736730599/350933496730597. 350437736730607/350933496730605. 350437736730615/350933496730613. 350437
736730623/350933496730621. 350437736730631/350933496730639. 350437736730649/350933496730647. 350437736730656/350933496730654. 350
437736730664/350933496730662. 350437736730672/350933496730670. 350437736730680/350933496730688. 350437736730698/350933496730696.
350437736730706/350933496730704. 350437736730714/350933496730712. 350437736730722/350933496730720. 350437736730730/35093349673073
8. 350437736730748/350933496730746. 350437736730755/350933496730753. 350437736730763/350933496730761. 350437736730771/35093349673
0779.350437736730789/350933496730787. 350437736730797/350933496730795. 350437736730805/350933496730803. 350437736730813/350933496
730811. 350437736730821/350933496730829. 350437736730839/350933496730837. 350437736730847/350933496730845. 350437736730854/350933
496730852. 350437736730862/350933496730860. 350437736730870/350933496730878. 350437736730888/350933496730886. 350437736730896/350
933496730894. 350437736730904/350933496730902. 350437736730912/350933496730910. 350437736730920/350933496730928. 350437736730938/
350933496730936. 350437736730946/350933496730944.350437736730953/350933496730951. 350437736730961/350933496730969. 35043773673097
9/350933496730977. 350437736730987/350933496730985. 350437736730995/350933496730993. 350437736731001/350933496731009. 35043773673
1019/350933496731017. 350437736731027/350933496731025. 350437736731035/350933496731033XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025001155822-6
Espacio para uso exclusivo de la Entidad Recaudadora
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