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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
032025001337716-5
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
1075625444
30 . Apellidos y nombres
JULIAN APONTE HERNANDEZ
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. 116575015841231
43 . Año – Mes – Día
2025 – 07 – 24
44 . Documento de transporte
No. 45T0400338
45 . Año – Mes – Día
2025 – 07 – 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
9103636833
52 . Año – Mes – Día
2025 – 07 – 18
53 . Cod. país
procedencia
855
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.
4.016.44
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.
128.00
72 . Peso neto kgs. dcms.
117.76
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
44.498.58
79 . Valor fletes USD
1.031.68 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
182.875.582
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
182.875.582
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
1.50
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.033.18
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
45.531.76
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: 566288-DECL: 1937106-DO: 893117917251- 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: 3094213182. ID DELIVERY: 6083323067. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A165MZKILTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A16 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
032025001337716
133. Feha: 202507 22
134 . Levante No. 032025001120487 135 . Fecha
2025 – 07 – 25
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 92032505629400
Fecha presentación 2025-07-22 15:32:48
Valor pagado $0.00
Fecha de Impresión: 2025-07-25 13:18:40
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001337716-5
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DELO: SM-A165M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A165M/DS,BLACK,LTC( QTY. 400,00 u )(400,00 PCE);
IMEIS: 356927261442747/358318111442749. 356927261442754/358318111442756. 356927261442762/358318111442764. 356927261442770/3583181
11442772. 356927261442788/358318111442780. 356927261442796/358318111442798. 356927261442812/358318111442814.356927261442820/35831
8111442822. 356927261442838/358318111442830. 356927261442937/358318111442939. 356927261442952/358318111442954. 356927261442960/35
8318111442962. 356927261443661/358318111443663. 356927261443695/358318111443697. 356927261443729/358318111443721. 356927261443745
/358318111443747. 356927261443752/358318111443754. 356927261443760/358318111443762. 356927261443778/358318111443770. 356927261443
786/358318111443788. 356927261443794/358318111443796. 356927261443810/358318111443812. 356927261443844/358318111443846. 356927261
443893/358318111443895. 356927261443935/358318111443937. 356927261443943/358318111443945. 35 6927261443984/358318111443986. 35692
7261444032/358318111444034. 356927261444040/358318111444042. 356927261444115/358318111444117. 356927261444164/358318111444166. 35
6927261444214/358318111444216. 356927261444552/358318111444554. 356927261444560/358318111444562. 356927261444586/358318111444588.
356927261444594/358318111444596. 356927261444602/358318111444604. 356927261444610/358318111444612. 356927261444628/3583181114446
20. 356927261444644/358318111444646. 356927261444651/358318111444653. 356927261444669/358318111444661. 356927261444677/3583181114
44679. 356927261444685/358318111444687. 356927261444693/358318111444695. 356927261444701/358318111444703. 356927261444719/3583181
11444711. 356927261444727/358318111444729. 356927261444735/358318111444737. 356927261444743/358318111444745. 356927261444750/3583
18111444752. 356927261444768/358318111444760. 356927261444776/358318111444778. 356927261444784/358318111444786. 356927261444792/3
58318111444794. 356927261444800/358318111444802. 356927261444826/358318111444828. 356927261444842/358318111444844. 35692726144488
3/358318111444885. 356927261444891/358318111444893.356927261444917/358318111444919. 356927261444925/358318111444927. 356927261444
974/358318111444976. 356927261445013/358318111445015. 356927261445047/358318111445049. 356927261445054/358318111445056. 356927261
445062/358318111445064. 356927261445070/358318111445072. 356927261445088/358318111445080. 356927261445096/358318111445098. 356927
261445112/358318111445114. 356927261445120/358318111445122. 356927261445138/358318111445130. 356927261445146/358318111445148. 356
927261445153/358318111445155. 356927261445179/358318111445171. 356927261445187/358318111445189.356927261445195/358318111445197. 3
56927261445211/358318111445213. 356927261445229/358318111445221. 356927261445237/358318111445239. 356927261445260/358318111445262
. 356927261445278/358318111445270. 356927261445286/358318111445288. 356927261445310/358318111445312. 356927261445328/358318111445
320. 356927261445336/358318111445338. 356927261445385/358318111445387. 356927261445401/358318111445403. 356927261445427/358318111
445429. 356927261445476/358318111445478. 356927261445484/358318111445486. 356927261445526/358318111445528. 356927261445542/358318
111445544. 356927261445559/358318111445551. 356927261445591/358318111445593. 356927261445641/358318111445643. 356927261445674/358
318111445676. 356927261445682/358318111445684. 356927261445708/358318111445700. 356927261445716/358318111445718. 356927261445724/
358318111445726. 356927261445732/358318111445734. 356927261445740/358318111445742. 356927261445757/358318111445759. 3569272614457
65/358318111445767. 356927261445781/358318111445783. 356927261445799/358318111445791. 356927261445815/358318111445817. 3569272614
45823/358318111445825. 356927261445831/358318111445833. 356927261445849/358318111445841. 356927261445856/358318111445858. 3569272
61445864/358318111445866. 356927261445872/358318111445874. 356927261445880/358318111445882. 356927261445898/358318111445890. 3569
27261445914/358318111445916. 356927261445922/358318111445924. 356927261445930/358318111445932. 356927261445948/358318111445940. 3
56927261445955/358318111445957. 356927261445963/358318111445965. 356927261445971/358318111445973. 356927261445989/358318111445981
. 356927261445997/358318111445999. 356927261446003/358318111446005. 356927261446011/358318111446013. 356927261446037/358318111446
039. 356927261446045/358318111446047.356927261446060/358318111446062. 356927261446078/358318111446070. 356927261446102/3583181114
46104. 356927261446128/358318111446120. 356927261446185/358318111446187. 356927261446193/358318111446195. 356927261446219/3583181
11446211. 356927261446243/358318111446245. 356927261446250/358318111446252. 356927261446268/358318111446260. 356927261446276/3583
18111446278. 356927261446326/358318111446328. 356927261446334/358318111446336. 356927261446359/358318111446351. 356927261446367/3
58318111446369. 356927261446409/358318111446401. 356927261446458/358318111446450.356927261446490/358318111446492. 356927261446524
/358318111446526. 356927261446532/358318111446534. 356927261446540/358318111446542. 356927261446557/358318111446559. 356927261446
565/358318111446567. 356927261446573/358318111446575. 356927261446599/358318111446591. 356927261446615/358318111446617. 356927261
446631/358318111446633. 356927261446664/358318111446666. 356927261446672/358318111446674. 356927261446680/358318111446682. 356927
261446714/358318111446716. 356927261446730/358318111446732. 356927261446748/358318111446740. 356927261446771/358318111446773. 356
927261446789/358318111446781. 356927261446797/358318111446799. 356927261446821/358318111446823. 356927261446839/358318111446831.
356927261446847/358318111446849. 356927261446854/358318111446856. 356927261446862/358318111446864. 356927261446870/35831811144687
2. 356927261446904/358318111446906. 356927261446920/358318111446922. 356927261446938/358318111446930. 356927261446987/35831811144
6989. 356927261447043/358318111447045. 356927261447050/358318111447052. 356927261447084/358318111447086. 356927261447142/35831811
1447144. 356927261447167/358318111447169. 356927261447266/358318111447268. 356927261447431/358318111447433. 356927261447498/35831
8111447490. 356927261447506/358318111447508. 356927261447522/358318111447524. 356927261447530/358318111447532. 356927261447548/35
8318111447540. 356927261447571/358318111447573. 356927261447597/358318111447599. 356927261447605/358318111447607. 356927261447613
/358318111447615. 356927261447621/358318111447623. 356927261447639/358318111447631. 356927261447647/358318111447649. 356927261447
654/358318111447656. 356927261447688/358318111447680. 356927261447746/358318111447748. 356927261447761/358318111447763. 356927261
448082/358318111448084.356927261448165/358318111448167. 356927261448215/358318111448217. 356927261448314/358318111448316. 3569272
61448397/358318111448399. 356927261448421/358318111448423. 356927261448462/358318111448464. 356927261448504/358318111448506. 3569
27261448603/358318111448605. 356927261448736/358318111448738. 356927261448801/358318111448803. 356927261448991/358318111448993. 3
56927261449031/358318111449033. 356927261449056/358318111449058. 356927261449080/358318111449082. 356927261449171/358318111449173
. 356927261449189/358318111449181. 356927261449197/358318111449199.356927261449205/358318111449207. 356927261449221/3583181114492
23. 356927261449239/358318111449231. 356927261449262/358318111449264. 356927261449379/358318111449371. 356927261449403/3583181114
49405. 356927261449411/358318111449413. 356927261449429/358318111449421. 356927261449437/358318111449439. 356927261449452/3583181
11449454. 356927261449460/358318111449462. 356927261449478/358318111449470. 356927261449486/358318111449488. 356927261449494/3583
18111449496. 356927261449502/358318111449504. 356927261449510/358318111449512. 356927261449544/358318111449546. 356927261449551/3
58318111449553. 356927261449585/358318111449587. 356927261449593/358318111449595. 356927261449601/358318111449603. 35692726144961
9/358318111449611. 356927261449627/358318111449629. 356927261449635/358318111449637. 356927261449643/358318111449645. 35692726144
9650/358318111449652. 356927261449668/358318111449660. 356927261449692/358318111449694. 356927261449700/358318111449702. 35692726
1449718/358318111449710. 356927261449726/358318111449728. 356927261449734/358318111449736. 356927261449742/358318111449744. 35692
7261449759/358318111449751. 356927261449767/358318111449769. 356927261449783/358318111449785. 356927261449791/358318111449793. 35
6927261449825/358318111449827. 356927261449833/358318111449835. 356927261449858/358318111449850. 356927261449866/358318111449868.
356927261449882/358318111449884. 356927261449890/358318111449892. 356927261449916/358318111449918. 356927261449957/3583181114499
59. 356927261449965/358318111449967. 356927261449973/358318111449975. 356927261449981/358318111449983. 356927261450005/3583181114
50007. 356927261450013/358318111450015. 356927261450021/358318111450023. 356927261450070/358318111450072. 356927261450104/3583181
11450106.356927261450120/358318111450122. 356927261450146/358318111450148. 356927261450153/358318111450155. 356927261450161/35831
8111450163. 356927261450179/358318111450171. 356927261450187/358318111450189. 356927261450195/358318111450197. 356927261450237/35
8318111450239. 356927261450252/358318111450254. 356927261450278/358318111450270. 356927261450286/358318111450288. 356927261450294
/358318111450296. 356927261450302/358318111450304. 356927261450310/358318111450312. 356927261450328/358318111450320. 356927261450
344/358318111450346. 356927261450351/358318111450353.356927261450369/358318111450361. 356927261450377/358318111450379. 3569272614
032025001337716-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001337716-5
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
50393/358318111450395. 356927261450401/358318111450403. 356927261450419/358318111450411. 356927261450435/358318111450437. 3569272
61450443/358318111450445. 356927261450450/358318111450452. 356927261450484/358318111450486. 356927261450559/358318111450551. 3569
27261450617/358318111450619. 356927261450625/358318111450627. 356927261450633/358318111450635. 356927261450658/358318111450650. 3
56927261450666/358318111450668. 356927261450690/358318111450692. 356927261450724/358318111450726. 356927261450807/358318111450809
. 356927261450815/358318111450817. 356927261450823/358318111450825. 356927261450856/358318111450858. 356927261450864/358318111450
866. 356927261450898/358318111450890. 356927261450906/358318111450908. 356927261450922/358318111450924. 356927261450930/358318111
450932. 356927261450948/358318111450940. 356927261450955/358318111450957. 356927261450963/358318111450965. 356927261450971/358318
111450973. 356927261450989/358318111450981. 356927261450997/358318111450999. 356927261451011/358318111451013. 356927261451045/358
318111451047. 356927261451052/358318111451054. 356927261451060/358318111451062. 356927261451078/358318111451070. 356927261451086/
358318111451088. 356927261451094/358318111451096. 356927261451102/358318111451104. 356927261451110/358318111451112. 3569272614511
28/358318111451120. 356927261451144/358318111451146. 356927261451151/358318111451153. 356927261451169/358318111451161. 3569272614
51177/358318111451179. 356927261451185/358318111451187. 356927261451193/358318111451195. 356927261451201/358318111451203. 3569272
61451219/358318111451211. 356927261451227/358318111451229. 356927261451235/358318111451237. 356927261451243/358318111451245.35692
7261451250/358318111451252. 356927261451268/358318111451260. 356927261451276/358318111451278. 356927261451284/358318111451286. 35
6927261451300/358318111451302. 356927261451318/358318111451310. 356927261451326/358318111451328. 356927261451334/358318111451336.
356927261451342/358318111451344. 356927261451359/358318111451351. 356927261451367/358318111451369. 356927261451383/3583181114513
85. 356927261451391/358318111451393. 356927261451417/358318111451419. 356927261451425/358318111451427. 356927261451433/3583181114
51435. 356927261451441/358318111451443.356927261451508/358318111451500. 356927261451698/358318111451690. 356927261451706/35831811
1451708. 356927261451714/358318111451716. 356927261452027/358318111452029. 356927261452159/358318111452151. 356927261452167/35831
8111452169. 356927261452191/358318111452193. 356927261452233/358318111452235. 356927261452258/358318111452250. 356927261452266/35
8318111452268. 356927261452316/358318111452318. 356927261452332/358318111452334. 356927261452399/358318111452391. 356927261452423
/358318111452425. 356927261452449/358318111452441. 356927261452464/358318111452466. 356927261453108/358318111453100. 356927261453
157/358318111453159. 356927261453330/358318111453332. 356927261453603/358318111453605. 356927261453892/358318111453894. 356927261
454387/358318111454389. 356927261454759/358318111454751. 356927261454924/358318111454926. 356927261469096/358318111469098. 356927
261469104/358318111469106. 356927261469112/358318111469114. 356927261469120/358318111469122. 356927261469138/358318111469130. 356
927261469146/358318111469148. 356927261469153/358318111469155. 356927261469179/358318111469171. 356927261469187/358318111469189.
356927261469195/358318111469197. 356927261469203/358318111469205. 356927261469211/358318111469213. 356927261469229/35831811146922
1. 356927261469237/358318111469239. 356927261469252/358318111469254. 356927261469310/358318111469312. 356927261469351/35831811146
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032025001337716-5
Espacio para uso exclusivo de la Entidad Recaudadora
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