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REPÚBLICA DE COLOMBIA
Declaración de Importación
Privada
500
1. Año 2024
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032024000471186-1
5 . Número de Identificación Tributaria (NIT)
830028931 13 . Dirección
CR 7 113 43 OF 607
6 . DV. 5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
15 . Teléfono 12 . Cód. Admón. 16 . Cód. Dpto 17 . Cód. Ciudad Municipio
4870707 03 11 001
24 . Número de Identificación Tributaria (NIT)
860536003
29 . Número documento de identificación
1075625444
25 . DV. 3
26 . Razón social del declarante autorizado 27 . Tipo usuario 28 . Cód. usuario
AGENCIA DE ADUANAS ABC REPECEV S.A.S. NIVEL 1 26 99 30 . Apellidos y nombres
JULIAN APONTE HERNANDEZ
31 . Clase 32 . Tipo declaración 33 . Cod. 34 .No.Formulario Anterior 35 . Año – Mes – Día 36 . Cod. Admón. 37 . Declaración de Exportación 38 . Año – Mes – Día 39 . Cod. Admón. Importador Anticipada 3 XXXXXXXXXXXXXX XXXX – XX – XX XX No. XXXXXXXXXXXXXXX XXXX – XX – XX XX
02
40 . Cod. lugar ingreso 41 . Cod. Depósito 42 . Manifiesto de carga 43 . Año – Mes – Día 44 . Documento de transporte 45 . Año – Mes – Día de las mercancías 99900 No. 116575014314997 2024 – 04 – 13 No. KHAN24045896 2024 – 04 – 07
BOG
46 . Nombre exportador o proveedor en el exterior 47 . Ciudad 48 . Cod.País Exportador SAMSUNG ELECTRONICS CO., LTD GYEONGGI-DO 190
49 . Dirección exportador o proveedor en el exterior 50 . E-mail
129, SAMSUNG-RO, YEONGTONG-GU SUWON 16677 010-8705-6749
51 . No. de factura 52 . Año – Mes – Día 53 . Cod. país 9102490804 2024 – 04 – 06 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
249
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. DHL AERO EXPRESO S A SUCURSAL COLOMBIA
3.775.37
S
59 . Subpartida arancelaria 60 . Cod. 8517130000 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 67 . Cod. Acuerdo de origen XXX
855
68 . Forma de pago 69 . Tipo de 70 . Cod. país de la importación importación compra
01 01 190
71 . Peso bruto kgs. dcms.
72 . Peso neto kgs.
dcms. 73 . Código 84.00 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
107.00
300.00
78 .Valor FOB 79 . Valor fletes USD USD
76.156.92
766.12
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
3.72
0
Arancel
0
0
0.00
92 93 94 0.00 290.426.982
95
96
I.V.A.
9798 99 100 101
0.00 290.426.982 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
769.84
0.00
Salvaguardia
102 103 104 105 106
0.00 0 0 0 0.00
Derechos 107 Compensatorios
108
109
110
111
0.00
0
0
0
0.00
84 . Valor aduana 85 . Código registro 86 . Número
USD
o licencia
76.926.76
X XXXXXXXXXX
Derechos 112 Antidumping
113
114
115
116
0.00
0
0
0
0.00
Sancion
117 118 119 120 0000
87 . Cod. oficina
99
88 . Año 89 . Programa No 90 . Cód Interno del XXXX XXXXXXXXXX Producto
0
Rescate
121 122 123 124 0000
Total
125 126 0
0.00
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: 512734-DECL: 1782848-DO: 893107609241- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN)// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCAN
CIA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3062232847. ID CONTENED
OR: 6075007638. MERCANCIA MARCA: SAMSUNGREFERENCIA: SM-A356ELBGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A35 5G DUOS (CON ACCESORIOS
PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL CLARO, MODELO: SM-A356E/DS, USO O DESTINO: PARA LA VENTA AL(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 032024000471186
133. Feha: 202404 09
134 . Levante No. 032024000475225 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 04 – 15
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 92032402584805
Fecha presentación 2024-04-09 15:59:19 Valor pagado $0.00
Fecha de Impresión: 2024-04-15 14:08:06
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000471186-1 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MAYOR Y AL DETAL/ /MOBILE,SM-A356E/DS,LIGHT BLUE,LTC( QTY. 300,00 u )(300,00 PCE);IMEIS: 357435843088581/357653503088580. 357435
843088615/357653503088614. 357435843088623/357653503088622. 357435843088649/357653503088648. 357435843088664/357653503088663. 357
435843088698/357653503088697. 357435843088714/357653503088713. 357435843088722/357653503088721. 357435843088748/357653503088747.
357435843088805/357653503088804. 357435843088813/357653503088812. 357435843088821/357653503088820. 357435843088839/35765350308883
8. 357435843088862/357653503088861. 357435843088870/357653503088879. 357435843088888/357653503088887. 357435843088938/35765350308
8937. 357435843088953/357653503088952. 357435843088961/357653503088960. 357435843088979/357653503088978. 357435843088987/35765350
3088986.357435843088995/357653503088994. 357435843089001/357653503089000. 357435843089027/357653503089026. 357435843089050/357653
503089059. 357435843089076/357653503089075. 357435843089084/357653503089083. 357435843089 100/357653503089109. 357435843089126/35
7653503089125. 357435843089142/357653503089141. 357435843089159/357653503089158. 357435843089209/357653503089208. 357435843089217
/357653503089216. 357435843089241/357653503089240. 357435843089258/357653503089257. 357435843089266/357653503089265. 357435843089
274/357653503089273. 357435843089282/357653503089281.357435843089290/357653503089299. 357435843089308/357653503089307. 3574358430
89340/357653503089349. 357435843089423/357653503089422. 357435843089530/357653503089539. 357435843089548/357653503089547. 3574358
43089555/357653503089554. 357435843089571/357653503089570. 357435843089613/357653503089612. 357435843089647/357653503089646. 3574
35843089654/357653503089653. 357435843089688/357653503089687. 357435843089696/357653503089695. 357435843089712/357653503089711. 3
57435843089738/357653503089737. 357435843089746/357653503089745. 357435843089761/357653503089760. 357435843089779/357653503089778
. 357435843089787/357653503089786. 357435843089803/357653503089802. 357435843089811/357653503089810. 357435843089860/357653503089
869. 357435843089928/357653503089927. 357435843089993/357653503089992. 357435843090017/357653503090016. 357435843090025/357653503
090024. 357435843090033/357653503090032. 357435843090058/357653503090057. 357435843090066/357653503090065. 357435843090074/357653
503090073. 357435843090124/357653503090123. 357435843090173/357653503090172. 357435843090223/357653503090222. 357435843090256/357
653503090255. 357435843090264/357653503090263. 357435843090272/357653503090271. 357435843090298/357653503090297. 357435843090306/
357653503090305. 357435843090355/357653503090354. 357435843090371/357653503090370. 357435843090389/357653503090388. 3574358430903
97/357653503090396. 357435843090439/357653503090438. 357435843090454/357653503090453. 357435843090512/357653503090511. 3574358430
90520/357653503090529. 357435843090546/357653503090545. 357435843090561/357653503090560. 357435843090579/357653503090578. 3574358
43090587/357653503090586. 357435843090595/357653503090594. 357435843090611/357653503090610. 357435843090629/357653503090628.35743
5843090686/357653503090685. 357435843090702/357653503090701. 357435843090710/357653503090719. 357435843090736/357653503090735. 35
7435843090744/357653503090743. 357435843090769/357653503090768. 357435843090777/357653503090776. 357435843090785/357653503090784.
357435843090827/357653503090826. 357435843090843/357653503090842. 357435843090868/357653503090867. 357435843090876/3576535030908
75. 357435843090892/357653503090891. 357435843090900/357653503090909. 357435843090967/357653503090966. 357435843090975/3576535030
90974. 357435843090983/357653503090982.357435843091015/357653503091014. 357435843091031/357653503091030. 357435843091056/35765350
3091055. 357435843091114/357653503091113. 357435843091163/357653503091162. 357435843091262/357653503091261. 357435843091395/35765
3503091394. 357435843091445/357653503091444. 357435843091502/357653503091501. 357435843091601/357653503091600. 357435843091718/35
7653503091717. 357435843091775/357653503091774. 357435843091791/357653503091790. 357435843091809/357653503091808. 357435843091874
/357653503091873. 357435843091932/357653503091931. 357435843091973/357653503091972. 357435843091981/357653503091980. 357435843092
039/357653503092038. 357435843092054/357653503092053. 357435843092088/357653503092087. 357435843092104/357653503092103. 357435843
092146/357653503092145. 357435843092211/357653503092210. 357435843092252/357653503092251. 357435843092526/357653503092525. 357435
843092567/357653503092566. 357435843092583/357653503092582. 357435843092591/357653503092590. 357435843092609/357653503092608. 357
435843092625/357653503092624. 357435843092633/357653503092632. 357435843092658/357653503092657. 357435843092666/357653503092665.
357435843092682/357653503092681. 357435843092773/357653503092772. 357435843092781/357653503092780. 357435843092807/35765350309280
6. 357435843092823/357653503092822. 357435843092856/357653503092855. 357435843092864/357653503092863. 357435843092922/35765350309
2921. 357435843092930/357653503092939. 357435843092971/357653503092970. 357435843093011/357653503093010. 357435843093037/35765350
3093036. 357435843093045/357653503093044. 357435843093060/357653503093069. 357435843093078/357653503093077. 357435843093086/35765
3503093085. 357435843093094/357653503093093. 357435843093110/357653503093119. 357435843093128/357653503093127.357435843093144/357
653503093143. 357435843093201/357653503093200. 357435843093219/357653503093218. 357435843093235/357653503093234. 357435843093342/
357653503093341. 357435843093359/357653503093358. 357435843093375/357653503093374. 357435843093391/357653503093390. 3574358430934
25/357653503093424. 357435843093458/357653503093457. 357435843093516/357653503093515. 357435843093532/357653503093531. 3574358430
93557/357653503093556. 357435843093565/357653503093564. 357435843093573/357653503093572. 357435843093599/357653503093598. 3574358
43093607/357653503093606.357435843093623/357653503093622. 357435843097665/357653503097664. 357435843102374/357653503102373. 35743
5843102382/357653503102381. 357435843102390/357653503102399. 357435843103695/357653503103694. 357435843103703/357653503103702. 35
7435843103711/357653503103710. 357435843103745/357653503103744. 357435843103760/357653503103769. 357435843103778/357653503103777.
357435843103794/357653503103793. 357435843103844/357653503103843. 357435843103869/357653503103868. 357435843103877/3576535031038
76. 357435843103885/357653503103884. 357435843103893/357653503103892. 357435843103927/357653503103926. 357435843103976/3576535031
03975. 357435843104008/357653503104007. 357435843104032/357653503104031. 357435843104040/357653503104049. 357435843104057/3576535
03104056. 357435843104065/357653503104064. 357435843104073/357653503104072. 357435843104107/357653503104106. 357435843104115/3576
53503104114. 357435843104123/357653503104122. 357435843104131/357653503104130. 357435843104156/357653503104155. 357435843104172/3
57653503104171. 357435843104180/357653503104189. 357435843104198/357653503104197. 357435843104206/357653503104205. 35743584310421
4/357653503104213. 357435843104222/357653503104221. 357435843104230/357653503104239. 357435843104248/357653503104247. 35743584310
4255/357653503104254. 357435843104263/357653503104262. 357435843104289/357653503104288. 357435843104297/357653503104296. 35743584
3104339/357653503104338. 357435843104347/357653503104346. 357435843104388/357653503104387. 357435843104396/357653503104395. 35743
5843104404/357653503104403. 357435843104453/357653503104452. 357435843104487/357653503104486. 357435843104495/357653503104494. 35
7435843104511/357653503104510. 357435843104537/357653503104536. 357435843104552/357653503104551.357435843104610/357653503104619.
357435843104701/357653503104700. 357435843104735/357653503104734. 357435843104768/357653503104767. 357435843104875/35765350310487
4. 357435843216588/357653503216587. 357435843216596/357653503216595. 357435843216604/357653503216603. 357435843216620/35765350321
6629. 357435843216638/357653503216637. 357435843216679/357653503216678. 357435843216687/357653503216686. 357435843216703/35765350
3216702. 357435843216711/357653503216710. 357435843216737/357653503216736. 357435843216752/357653503216751. 357435843295491/35765
3503295490.357435843295509/357653503295508. 357435843295525/357653503295524. 357435843295558/357653503295557. 357435843295608/357
653503295607. 357435843295616/357653503295615. 357435843295632/357653503295631. 357435843295665/357653503295664. 357435843295707/
357653503295706. 357435843087583/357653503087582. 357435843087591/357653503087590. 357435843087633/357653503087632. 3574358430876
41/357653503087640. 357435843087666/357653503087665. 357435843087815/357653503087814. 357435843087823/357653503087822. 3574358430
87849/357653503087848. 357435843087856/357653503087855. 357435843087864/357653503087863. 357435843087872/357653503087871. 3574358
43087898/357653503087897. 357435843087914/357653503087913. 357435843087922/357653503087921. 357435843087930/357653503087939. 3574
35843087948/357653503087947. 357435843087955/357653503087954. 357435843087963/357653503087962. 357435843087971/357653503087970. 3
57435843087989/357653503087988. 357435843087997/357653503087996. 357435843088003/357653503088002. 357435843088011/357653503088010
. 357435843088029/357653503088028. 357435843088045/357653503088044. 357435843088052/357653503088051. 357435843088094/357653503088
093. 357435843088110/357653503088119. 357435843088128/357653503088127. 357435843088136/357653503088135. 357435843088169/357653503
088168. 357435843088177/357653503088176. 357435843088219/357653503088218. 357435843088235/357653503088234. 357435843088375/357653
032024000471186-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000471186-1 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
503088374. 357435843088425/357653503088424. 357435843088433/357653503088432. 357435843088441/357653503088440. 357435843088458/357
653503088457. 357435843088482/357653503088481. 357435843088490/357653503088499. 357435843088516/357653503088515. 357435843088524/
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032024000471186-1
Espacio para uso exclusivo de la Entidad Recaudadora
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