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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
032024000512739-1
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. 116575014332943 2024 – 04 – 19 No. SHAN0310234 2024 – 04 – 11
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 9102501541 2024 – 04 – 11 procedencia 855
54 . Cod. Modo Transporte
4
55 . Código de Bandera
169
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. TAMPA CARGO S.A.S.
3.820.10
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 120.00 embalaje
YY
74 . No. bultos 1
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
154.00
500.00
78 .Valor FOB 79 . Valor fletes USD USD
73.696.23
1.102.64
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
3.62
0
Arancel
0
0
0.00
92 93 94 0.00 285.752.992
95
96
I.V.A.
9798 99 100 101
0.00 285.752.992 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.106.26
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
74.802.49
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: 513698-DECL: 1786158-DO: 893108100241- 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: 3062693010. ID CONTENEDOR: 6075123708. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A155MZKILTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A15 5G DUOS, (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGR(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 032024000512739
133. Feha: 202404 16
134 . Levante No. 032024000510474 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 04 – 22
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 92032402801913
Fecha presentación 2024-04-16 20:35:31 Valor pagado $0.00
Fecha de Impresión: 2024-04-22 11:19:34
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000512739-1 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
O, MODELO: SM-A155M/DSN, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A155M/DSN,BLACK,LTC( QTY. 500,00 u )(500,00
PCE); IMEIS: 355170560101679/355533000101676. 355170560101687/355533000101684. 355170560101695/355533000101692. 355170560101711/
355533000101718. 355170560101752/355533000101759. 355170560101794/355533000101791. 355170560101802/355533000101809. 3551705601018
28/355533000101825. 355170560101844/355533000101841. 355170560101851/355533000101858. 355170560101877/355533000101874.35517056010
1919/355533000101916. 355170560101927/355533000101924. 355170560101984/355533000101981. 355170560102016/355533000102013. 35517056
0102065/355533000102062. 355170560102115/355533000102112. 355170560102164/355533000102161. 355170560102172/355533000102179. 35517
0560102198/355533000102195. 355170560102206/355533000102203. 355170560102214/355533000102211. 355170560102248/355533000102245. 35
5170560102255/355533000102252. 355170560102271/355533000102278. 355170560102321/35553300010 2328. 355170560102339/355533000102336
. 355170560102388/355533000102385. 355170560102446/355533000102443. 355170560102495/355533000102492. 355170560102529/355533000102
526. 355170560102560/355533000102567. 355170560102610/355533000102617. 355170560102628/355533000102625. 355170560102685/355533000
102682. 355170560102701/355533000102708. 355170560102750/355533000102757. 355170560102776/355533000102773. 355170560102800/355533
000102807. 355170560102867/355533000102864. 355170560102974/355533000102971. 355170560103006/355533000103003. 355170560103063/355
533000103060. 355170560103097/355533000103094. 355170560103162/355533000103169. 355170560103279/355533000103276. 355170560103295/
355533000103292. 355170560103485/355533000103482. 355170560103519/355533000103516. 355170560103568/355533000103565. 3551705601036
18/355533000103615. 355170560103634/355533000103631. 355170560103642/355533000103649. 355170560103659/355533000103656. 3551705601
03675/355533000103672. 355170560103691/355533000103698. 355170560103717/355533000103714. 355170560103725/355533000103722. 3551705
60103766/355533000103763. 355170560103782/355533000103789. 355170560103790/355533000103797. 355170560103808/355533000103805. 3551
70560103824/355533000103821. 355170560103857/355533000103854.355170560103881/355533000103888. 355170560103899/355533000103896. 35
5170560103907/355533000103904. 355170560103949/355533000103946. 355170560103980/355533000103987. 355170560104020/355533000104027.
355170560104046/355533000104043. 355170560104061/355533000104068. 355170560104079/355533000104076. 355170560104095/3555330001040
92. 355170560104145/355533000104142. 355170560104178/355533000104175. 355170560104186/355533000104183. 355170560104236/3555330001
04233. 355170560104269/355533000104266. 355170560104343/355533000104340. 355170560104350/355533000104357.355170560104376/35553300
0104373. 355170560104384/355533000104381. 355170560104392/355533000104399. 355170560104434/355533000104431. 355170560104459/35553
3000104456. 355170560104467/355533000104464. 355170560104475/355533000104472. 355170560104517/355533000104514. 355170560090054/35
5533000090051. 355170560090294/355533000090291. 355170560090336/355533000090333. 355170560090443/355533000090440. 355170560090450
/355533000090457. 355170560090500/355533000090507. 355170560090567/355533000090564. 355170560090724/355533000090721. 355170560090
831/355533000090838. 355170560090963/355533000090960. 355170560091060/355533000091067. 355170560097547/355533000097544. 355170560
097596/355533000097593. 355170560097687/355533000097684. 355170560097703/355533000097700. 355170560097729/355533000097726. 355170
560097737/355533000097734. 355170560097760/355533000097767. 355170560097836/355533000097833. 355170560097927/355533000097924. 355
170560097943/355533000097940. 355170560097968/355533000097965. 355170560097976/355533000097973. 355170560098032/355533000098039.
355170560098313/355533000098310. 355170560098370/355533000098377. 355170560098594/355533000098591. 355170560098719/35553300009871
6. 355170560098735/355533000098732. 355170560098883/355533000098880. 355170560100051/355533000100058. 355170560100085/35553300010
0082. 355170560100093/355533000100090. 355170560100168/355533000100165. 355170560100226/355533000100223. 355170560100242/35553300
0100249. 355170560100259/355533000100256. 355170560100267/355533000100264. 355170560100283/355533000100280. 355170560100291/35553
3000100298. 355170560100325/355533000100322. 355170560100333/355533000100330. 355170560100358/355533000100355. 355170560100366/35
5533000100363. 355170560100416/355533000100413.355170560100440/355533000100447. 355170560100507/355533000100504. 355170560100523/
355533000100520. 355170560100531/355533000100538. 355170560100556/355533000100553. 355170560100598/355533000100595. 3551705601006
14/355533000100611. 355170560100655/355533000100652. 355170560100663/355533000100660. 355170560100713/355533000100710. 3551705601
00721/355533000100728. 355170560100739/355533000100736. 355170560100788/355533000100785. 355170560100804/355533000100801. 3551705
60100820/355533000100827. 355170560100846/355533000100843. 355170560100853/355533000100850.355170560100879/355533000100876. 35517
0560100887/355533000100884. 355170560100903/355533000100900. 355170560101067/355533000101064. 355170560101117/355533000101114. 35
5170560101133/355533000101130. 355170560101141/355533000101148. 355170560101216/355533000101213. 355170560101232/355533000101239.
355170560101240/355533000101247. 355170560101307/355533000101304. 355170560101315/355533000101312. 355170560101323/3555330001013
20. 355170560101364/355533000101361. 355170560101372/355533000101379. 355170560101406/355533000101403. 355170560101422/3555330001
01429. 355170560101455/355533000101452. 355170560101463/355533000101460. 355170560101489/355533000101486. 355170560101513/3555330
00101510. 355170560101554/355533000101551. 355170560101570/355533000101577. 355170560101588/355533000101585. 355170560101596/3555
33000101593. 355170560101620/355533000101627. 355170560101653/355533000101650. 355170560104558/355533000104555. 355170560104566/3
55533000104563. 355170560104582/355533000104589. 355170560104707/355533000104704. 355170560104731/355533000104738. 35517056010486
3/355533000104860. 355170560105100/355533000105107. 355170560105142/355533000105149. 355170560105159/355533000105156. 35517056010
5241/355533000105248. 355170560105258/355533000105255. 355170560105274/355533000105271. 355170560105340/355533000105347. 35517056
0105407/355533000105404. 355170560105415/355533000105412. 355170560105449/355533000105446. 355170560105464/355533000105461. 35517
0560105480/355533000105487. 355170560105506/355533000105503. 355170560105555/355533000105552. 355170560105563/355533000105560. 35
5170560105589/355533000105586. 355170560105597/355533000105594. 355170560105605/355533000105602. 355170560105639/355533000105636.
355170560105662/355533000105669.355170560105787/355533000105784. 355170560105852/355533000105859. 355170560105936/35553300010593
3. 355170560106033/355533000106030. 355170560106090/355533000106097. 355170560106116/355533000106113. 355170560106207/35553300010
6204. 355170560106223/355533000106220. 355170560106256/355533000106253. 355170560106264/355533000106261. 355170560106314/35553300
0106311. 355170560106355/355533000106352. 355170560106512/355533000106519. 355170560106728/355533000106725. 355170560106942/35553
3000106949. 355170560106983/355533000106980. 355170560126429/355533000126426.355170560126528/355533000126525. 355170560126734/355
533000126731. 355170560126742/355533000126749. 355170560126783/355533000126780. 355170560126882/355533000126889. 355170560126932/
355533000126939. 355170560126940/355533000126947. 355170560126973/355533000126970. 355170560127021/355533000127028. 3551705601270
47/355533000127044. 355170560127070/355533000127077. 355170560127096/355533000127093. 355170560127161/355533000127168. 3551705601
27203/355533000127200. 355170560127294/355533000127291. 355170560127435/355533000127432. 355170560127476/355533000127473. 3551705
60127484/355533000127481. 355170560127492/355533000127499. 355170560127583/355533000127580. 355170560127641/355533000127648. 3551
70560127690/355533000127697. 355170560127831/355533000127838. 355170560127864/355533000127861. 355170560127872/355533000127879. 3
55170560128110/355533000128117. 355170560128144/355533000128141. 355170560128557/355533000128554. 355170560128565/355533000128562
. 355170560128797/355533000128794. 355170560128961/355533000128968. 355170560128987/355533000128984. 355170560129449/355533000129
446. 355170560129860/355533000129867. 355170560129936/355533000129933. 355170560130017/355533000130014. 355170560130207/355533000
130204. 355170560130959/355533000130956. 355170560131064/355533000131061. 355170560131080/355533000131087. 355170560131098/355533
000131095. 355170560131155/355533000131152. 355170560131171/355533000131178. 355170560131296/355533000131293. 355170560131304/355
533000131301. 355170560131361/355533000131368. 355170560131387/355533000131384. 355170560131445/355533000131442. 355170560131510/
355533000131517. 355170560131528/355533000131525. 355170560131569/355533000131566. 355170560131650/355533000131657. 3551705601317
75/355533000131772.355170560131783/355533000131780. 355170560131809/355533000131806. 355170560131866/355533000131863. 35517056013
1874/355533000131871. 355170560131908/355533000131905. 355170560131973/355533000131970. 355170560131999/355533000131996. 35517056
0132179/355533000132176. 355170560132203/355533000132200. 355170560132252/355533000132259. 355170560132328/355533000132325. 35517
0560132369/355533000132366. 355170560132401/355533000132408. 355170560132492/355533000132499. 355170560132526/355533000132523. 35
032024000512739-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024000512739-1 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
5170560132971/355533000132978. 355170560133029/355533000133026.355170560133045/355533000133042. 355170560133102/355533000133109.
355170560133128/355533000133125. 355170560133151/355533000133158. 355170560133326/355533000133323. 355170560133359/35553300013335
6. 355170560133441/355533000133448. 355170560133490/355533000133497. 355170560133557/355533000133554. 355170560133573/35553300013
3570. 355170560133581/355533000133588. 355170560133599/355533000133596. 355170560133649/355533000133646. 355170560133664/35553300
0133661. 355170560133714/355533000133711. 355170560133763/355533000133760. 355170560133797/355533000133794. 355170560133870/35553
3000133877. 355170560133888/355533000133885. 355170560133912/355533000133919. 355170560133938/355533000133935. 355170560133995/35
5533000133992. 355170560134001/355533000134008. 355170560134019/355533000134016. 355170560134076/355533000134073. 355170560134134
/355533000134131. 355170560134175/355533000134172. 355170560134183/355533000134180. 355170560134266/355533000134263. 355170560134
308/355533000134305. 355170560134316/355533000134313. 355170560134431/355533000134438. 355170560134480/355533000134487. 355170560
134498/355533000134495. 355170560134530/355533000134537. 355170560134563/355533000134560. 355170560134621/355533000134628. 355170
560134639/355533000134636. 355170560134696/355533000134693. 355170560134779/355533000134776. 355170560134787/355533000134784. 355
170560134878/355533000134875. 355170560134886/355533000134883. 355170560134894/355533000134891. 355170560134902/355533000134909.
355170560134928/355533000134925. 355170560134936/355533000134933. 355170560134944/355533000134941. 355170560135107/35553300013510
4. 355170560135123/355533000135120. 355170560135131/355533000135138. 355170560135149/355533000135146. 355170560135180/35553300013
5187.355170560135339/355533000135336. 355170560135370/355533000135377. 355170560135388/355533000135385. 355170560135511/355533000
135518. 355170560135537/355533000135534. 355170560135578/355533000135575. 355170560135800/355533000135807. 355170560135818/355533
000135815. 355170560135826/355533000135823. 355170560135867/355533000135864. 355170560135883/355533000135880. 355170560135909/355
533000135906. 355170560135917/355533000135914. 355170560135958/355533000135955. 355170560135966/355533000135963. 355170560135982/
355533000135989. 355170560136006/355533000136003.355170560136014/355533000136011. 355170560136030/355533000136037. 35517056013605
5/355533000136052. 355170560136188/355533000136185. 355170560136246/355533000136243. 355170560136287/355533000136284. 35517056013
6311/355533000136318. 355170560136337/355533000136334. 355170560136477/355533000136474. 355170560136485/355533000136482. 35517056
0136493/355533000136490. 355170560136501/355533000136508. 355170560136568/355533000136565. 355170560136584/355533000136581. 35517
0560136667/355533000136664. 355170560136675/355533000136672. 355170560136683/355533000136680. 355170560136709/355533000136706. 35
5170560136733/355533000136730. 355170560136741/355533000136748. 355170560136766/355533000136763. 355170560136782/355533000136789.
355170560136808/355533000136805. 355170560136824/355533000136821. 355170560136865/355533000136862. 355170560136907/3555330001369
04. 355170560136915/355533000136912. 355170560136956/355533000136953. 355170560136972/355533000136979. 355170560137038/3555330001
37035. 355170560137046/355533000137043. 355170560137053/355533000137050. 355170560137087/355533000137084. 355170560137111/3555330
00137118. 355170560137145/355533000137142. 355170560137160/355533000137167. 355170560137186/355533000137183. 355170560137194/3555
33000137191. 355170560137285/355533000137282. 355170560137327/355533000137324. 355170560137350/355533000137357. 355170560137368/3
55533000137365. 355170560137376/355533000137373. 355170560137392/355533000137399. 355170560137418/355533000137415. 35517056013744
2/355533000137449. 355170560137459/355533000137456. 355170560137483/355533000137480. 355170560137517/355533000137514. 35517056013
7533/355533000137530. 355170560137541/355533000137548. 355170560137566/355533000137563. 355170560137582/355533000137589.355170560
137590/355533000137597. 355170560137616/355533000137613. 355170560137632/355533000137639. 355170560137665/355533000137662. 355170
560137731/355533000137738. 355170560137848/355533000137845. 355170560137855/355533000137852. 355170560137947/355533000137944. 355
170560137954/355533000137951. 355170560137988/355533000137985. 355170560138010/355533000138017. 355170560138150/355533000138157.
355170560138168/355533000138165. 355170560138218/355533000138215. 355170560138309/355533000138306. 355170560138358/35553300013835
5. 355170560138416/355533000138413.355170560138507/355533000138504. 355170560138549/355533000138546. 355170560138556/355533000138
553. 355170560138572/355533000138579. 355170560138580/355533000138587. 355170560138630/355533000138637. 355170560138648/355533000
138645. 355170560138754/355533000138751. 355170560138846/355533000138843. 355170560138895/355533000138892. 355170560138929/355533
000138926. 355170560138960/355533000138967. 355170560138978/355533000138975. 355170560139083/355533000139080. 355170560140826/355
533000140823. 355170560140834/355533000140831. 355170560140859/355533000140856. 355170560140875/355533000140872. 355170560140883/
355533000140880. 355170560140891/355533000140898. 355170560140909/355533000140906. 355170560140925/355533000140922. 3551705601409
58/355533000140955. 355170560140966/355533000140963. 355170560140974/355533000140971. 355170560139109/355533000139106. 3551705601
39117/355533000139114. 355170560139141/355533000139148. 355170560139174/355533000139171. 355170560139190/355533000139197. 3551705
60139232/355533000139239. 355170560139281/355533000139288. 355170560139299/355533000139296. 355170560139323/355533000139320. 3551
70560139331/355533000139338. 355170560139372/355533000139379. 355170560139406/355533000139403. 355170560139422/355533000139429. 3
55170560139448/355533000139445. 355170560139471/355533000139478. 355170560139679/355533000139676. 355170560139729/355533000139726
. 355170560139737/355533000139734. 355170560139778/355533000139775. 355170560139786/355533000139783. 355170560139802/355533000139
809. 355170560139836/355533000139833. 355170560139877/355533000139874. 355170560139901/355533000139908. 355170560139950/355533000
139957. 355170560139984/355533000139981. 355170560139992/355533000139999. 355170560140008/355533000140005.355170560140024/3555330
00140021. 355170560140065/355533000140062. 355170560140073/355533000140070. 355170560140115/355533000140112. 355170560140123/3555
33000140120. 355170560140131/355533000140138. 355170560140198/355533000140195. 355170560140263/355533000140260. 355170560140313/3
55533000140310. 355170560140370/355533000140377. 355170560140412/355533000140419. 355170560140461/355533000140468. 35517056014058
6/355533000140583. 355170560140719/355533000140716. 355170560140735/355533000140732. 355170560140743/355533000140740XXXXXXXXXXXXX
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032024000512739-1
Espacio para uso exclusivo de la Entidad Recaudadora
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