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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
032024001248152-9
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
102294385
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
CARLOS ANDRES ROJAS MATAJUDIOS
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 Inicial 1 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. 116575014747362 2024 – 09 – 07 No. 734893023762 2024 – 09 – 05
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 9102857952 2024 – 09 – 05 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. FEDERAL EXPRESS CORPORATION
4.172.50
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
49.607.58
933.65
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
2.45
0
Arancel
0
0
0.00
92 93 94 0.00 210.893.505
95
96
I.V.A.
9798 99 100 101
0.00 210.893.505 0 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
936.10
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
50.543.68
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: 529990-DECL: 1837217-DO: 893120976241- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN) // NOSACOGEMOS: AL DECRETO 0925 DE 2013, MERC
ANCIA QUE NO REQUIERE REGISTRODE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3072685093. ID CONTEN
EDOR: 6077852934. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A155MZYILTC, PRODUCTO: TELEFONO CELULAR GALAXY A15 5GDUOS, (CON ACCESOR
IOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AMARILLO, MODELO: SM-A155M/DSN, USO O DESTINO: PARA LA VENTA (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 032024001248152
133. Feha: 202409 09
134 . Levante No. 032024001173023 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 09 – 09
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 92032406703709
Fecha presentación 2024-09-09 18:14:43 Valor pagado $0.00
Fecha de Impresión: 2024-09-09 18:14:49
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001248152-9 Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
AL MAYOR Y ALDETAL/ /MOBILE,SM-A155M/DSN,YELLOW,LTC( QTY. 500,00 u )(500,00 PCE); IMEIS: 355170561141328/355533001141325. 3551705
61141336/355533001141333. 355170561141344/355533001141341. 355170561141351/355533001141358. 355170561141369/355533001141366. 3551
70561141377/355533001141374. 355170561141385/355533001141382. 355170561141393/355533001141390. 355170561141401/355533001141408. 3
55170561141427/355533001141424. 355170561141443/355533001141440. 355170561141476/355533001141473. 355170561141492/355533001141499
. 355170561141500/355533001141507. 355170561141526/355533001141523. 355170561141534/355533001141531. 355170561141542/355533001141
549. 355170561141559/355533001141556. 355170561141567/355533001141564. 355170561141575/355533001141572. 355170561141609/355533001
141606. 355170561141617/355533001141614. 355170561141625/355533001141622. 355170561141633/355533001141630. 355170561141641/355533
001141648. 355170561141666/355533001141663. 355170561141674/355533001141671. 3551705611416 82/355533001141689. 355170561141690/35
5533001141697. 355170561141708/355533001141705. 355170561141716/355533001141713. 355170561141724/355533001141721. 355170561141732
/355533001141739. 355170561141740/355533001141747. 355170561141757/355533001141754. 355170561141765/355533001141762. 355170561141
773/355533001141770. 355170561141799/355533001141796.355170561141807/355533001141804. 355170561141815/355533001141812. 3551705611
41823/355533001141820. 355170561141831/355533001141838. 355170561141849/355533001141846. 355170561141856/355533001141853. 3551705
61141864/355533001141861. 355170561141872/355533001141879. 355170561141880/355533001141887. 355170561141898/355533001141895. 3551
70561141906/355533001141903. 355170561141914/355533001141911. 355170561141922/355533001141929. 355170561141930/355533001141937. 3
55170561141955/355533001141952. 355170561141963/355533001141960. 355170561141989/355533001141986.355170561142003/355533001142000.
355170561142011/355533001142018. 355170561142029/355533001142026. 355170561142037/355533001142034. 355170561142045/3555330011420
42. 355170561142060/355533001142067. 355170561142078/355533001142075. 355170561142086/355533001142083. 355170561142094/3555330011
42091. 355170561142102/355533001142109. 355170561142110/355533001142117. 355170561142136/355533001142133. 355170561142144/3555330
01142141. 355170561142151/355533001142158. 355170561142169/355533001142166. 355170561142177/355533001142174. 355170561142185/3555
33001142182. 355170561142193/355533001142190. 355170561142201/355533001142208. 355170561142219/355533001142216. 355170561142235/3
55533001142232. 355170561142243/355533001142240. 355170561142268/355533001142265. 355170561142284/355533001142281. 35517056114229
2/355533001142299. 355170561142300/355533001142307. 355170561142318/355533001142315. 355170561142334/355533001142331. 35517056114
2342/355533001142349. 355170561142359/355533001142356. 355170561142367/355533001142364. 355170561142375/355533001142372. 35517056
1142383/355533001142380. 355170561142391/355533001142398. 355170561142425/355533001142422. 355170561142433/355533001142430. 35517
0561142441/355533001142448. 355170561142458/355533001142455. 355170561142466/355533001142463. 355170561142474/355533001142471. 35
5170561142482/355533001142489. 355170561142508/355533001142505. 355170561142516/355533001142513. 355170561142524/355533001142521.
355170561142532/355533001142539. 355170561142540/355533001142547. 355170561142557/355533001142554. 355170561142573/3555330011425
70. 355170561142581/355533001142588. 355170561142599/355533001142596. 355170561142607/355533001142604. 355170561142615/3555330011
42612. 355170561142623/355533001142620.355170561142698/355533001142695. 355170561142706/355533001142703. 355170561142714/35553300
1142711. 355170561142722/355533001142729. 355170561142730/355533001142737. 355170561142748/355533001142745. 355170561142763/35553
3001142760. 355170561142771/355533001142778. 355170561142789/355533001142786. 355170561142797/355533001142794. 355170561142813/35
5533001142810. 355170561142821/355533001142828. 355170561142839/355533001142836. 355170561142847/355533001142844. 355170561142862
/355533001142869. 355170561142870/355533001142877. 355170561142888/355533001142885.355170561142896/355533001142893. 3551705611429
04/355533001142901. 355170561142912/355533001142919. 355170561142920/355533001142927. 355170561142938/355533001142935. 3551705611
42961/355533001142968. 355170561142987/355533001142984. 355170561143001/355533001143008. 355170561143019/355533001143016. 3551705
61143027/355533001143024. 355170561143035/355533001143032. 355170561143043/355533001143040. 355170561143050/355533001143057. 3551
70561143076/355533001143073. 355170561143084/355533001143081. 355170561143092/355533001143099. 355170561143100/355533001143107. 3
55170561143126/355533001143123. 355170561143134/355533001143131. 355170561143142/355533001143149. 355170561143159/355533001143156
. 355170561143167/355533001143164. 355170561143191/355533001143198. 355170561143209/355533001143206. 355170561143217/355533001143
214. 355170561143225/355533001143222. 355170561143233/355533001143230. 355170561143241/355533001143248. 355170561143258/355533001
143255. 355170561143266/355533001143263. 355170561143274/355533001143271. 355170561143290/355533001143297. 355170561143324/355533
001143321. 355170561143332/355533001143339. 355170561143340/355533001143347. 355170561143357/355533001143354. 355170561143365/355
533001143362. 355170561143381/355533001143388. 355170561143399/355533001143396. 355170561143415/355533001143412. 355170561143423/
355533001143420. 355170561143431/355533001143438. 355170561143472/355533001143479. 355170561143480/355533001143487. 3551705611434
98/355533001143495. 355170561143514/355533001143511. 355170561143530/355533001143537. 355170561143555/355533001143552. 3551705611
43589/355533001143586. 355170561143605/355533001143602. 355170561143613/355533001143610. 355170561143639/355533001143636. 3551705
61143647/355533001143644.355170561143654/355533001143651. 355170561143662/355533001143669. 355170561143670/355533001143677. 35517
0561143688/355533001143685. 355170561143696/355533001143693. 355170561143712/355533001143719. 355170561143720/355533001143727. 35
5170561143738/355533001143735. 355170561143746/355533001143743. 355170561143753/355533001143750. 355170561143779/355533001143776.
355170561143787/355533001143784. 355170561143803/355533001143800. 355170561143811/355533001143818. 355170561143837/3555330011438
34. 355170561143852/355533001143859. 355170561143860/355533001143867.355170561143878/355533001143875. 355170561143886/35553300114
3883. 355170561143894/355533001143891. 355170561143910/355533001143917. 355170561143928/355533001143925. 355170561143951/35553300
1143958. 355170561143969/355533001143966. 355170561143985/355533001143982. 355170561143993/355533001143990. 355170561144009/35553
3001144006. 355170561144017/355533001144014. 355170561144033/355533001144030. 355170561144041/355533001144048. 355170561144066/35
5533001144063. 355170561144074/355533001144071. 355170561144082/355533001144089. 355170561144108/355533001144105. 355170561144116
/355533001144113. 355170561144124/355533001144121. 355170561144132/355533001144139. 355170561144157/355533001144154. 355170561144
165/355533001144162. 355170561144173/355533001144170. 355170561144199/355533001144196. 355170561144207/355533001144204. 355170561
144215/355533001144212. 355170561144249/355533001144246. 355170561144264/355533001144261. 355170561144272/355533001144279. 355170
561144280/355533001144287. 355170561144306/355533001144303. 355170561144314/355533001144311. 355170561144322/355533001144329. 355
170561144348/355533001144345. 355170561144355/355533001144352. 355170561144363/355533001144360. 355170561144371/355533001144378.
355170561144389/355533001144386. 355170561144397/355533001144394. 355170561144405/355533001144402. 355170561144413/35553300114441
0. 355170561144421/355533001144428. 355170561144439/355533001144436. 355170561144447/355533001144444. 355170561144454/35553300114
4451. 355170561144462/355533001144469. 355170561144470/355533001144477. 355170561144488/355533001144485. 355170561144496/35553300
1144493. 355170561144504/355533001144501. 355170561144512/355533001144519. 355170561144520/355533001144527. 355170561144538/35553
3001144535.355170561144546/355533001144543. 355170561144553/355533001144550. 355170561144561/355533001144568. 355170561144579/355
533001144576. 355170561144595/355533001144592. 355170561144629/355533001144626. 355170561144652/355533001144659. 355170561144660/
355533001144667. 355170561144678/355533001144675. 355170561144686/355533001144683. 355170561144694/355533001144691. 3551705611447
02/355533001144709. 355170561144728/355533001144725. 355170561144736/355533001144733. 355170561144744/355533001144741. 3551705611
44751/355533001144758. 355170561144769/355533001144766.355170561144777/355533001144774. 355170561144785/355533001144782. 35517056
1144793/355533001144790. 355170561144801/355533001144808. 355170561144819/355533001144816. 355170561144827/355533001144824. 35517
0561144835/355533001144832. 355170561144843/355533001144840. 355170561144850/355533001144857. 355170561144868/355533001144865. 35
5170561144884/355533001144881. 355170561144892/355533001144899. 355170561213176/355533001213173. 355170561213184/355533001213181.
355170561213226/355533001213223. 355170561092265/355533001092262. 355170561093891/355533001093898. 355170561093925/3555330010939
22. 355170561094642/355533001094649. 355170561094998/355533001094995. 355170561138522/355533001138529. 355170561138530/3555330011
38537. 355170561138548/355533001138545. 355170561138563/355533001138560. 355170561138571/355533001138578. 355170561138589/3555330
032024001248152-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001248152-9 Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
01138586. 355170561138597/355533001138594. 355170561138639/355533001138636. 355170561138654/355533001138651. 355170561138662/3555
33001138669. 355170561138670/355533001138677. 355170561138688/355533001138685. 355170561138696/355533001138693. 355170561138704/3
55533001138701. 355170561138712/355533001138719. 355170561138720/355533001138727. 355170561138738/355533001138735. 35517056113874
6/355533001138743. 355170561138753/355533001138750. 355170561138761/355533001138768. 355170561138779/355533001138776. 35517056113
8787/355533001138784. 355170561138795/355533001138792. 355170561138803/355533001138800. 355170561138811/355533001138818. 35517056
1138829/355533001138826. 355170561138837/355533001138834. 355170561138845/355533001138842. 355170561138852/355533001138859. 35517
0561138860/355533001138867. 355170561138878/355533001138875. 355170561138894/355533001138891. 355170561138902/355533001138909.355
170561138910/355533001138917. 355170561138936/355533001138933. 355170561138944/355533001138941. 355170561138951/355533001138958.
355170561138969/355533001138966. 355170561138977/355533001138974. 355170561138993/355533001138990. 355170561139009/35553300113900
6. 355170561139025/355533001139022. 355170561139041/355533001139048. 355170561139058/355533001139055. 355170561139066/35553300113
9063. 355170561139074/355533001139071. 355170561139082/355533001139089. 355170561139090/355533001139097. 355170561139108/35553300
1139105. 355170561139132/355533001139139.355170561139140/355533001139147. 355170561139165/355533001139162. 355170561139181/355533
001139188. 355170561139207/355533001139204. 355170561139215/355533001139212. 355170561139223/355533001139220. 355170561139231/355
533001139238. 355170561139249/355533001139246. 355170561139256/355533001139253. 355170561139264/355533001139261. 355170561139306/
355533001139303. 355170561139314/355533001139311. 355170561139322/355533001139329. 355170561139330/355533001139337. 3551705611393
48/355533001139345. 355170561139363/355533001139360. 355170561139371/355533001139378. 355170561139397/355533001139394. 3551705611
39413/355533001139410. 355170561139439/355533001139436. 355170561139447/355533001139444. 355170561139454/355533001139451. 3551705
61139462/355533001139469. 355170561139470/355533001139477. 355170561139496/355533001139493. 355170561139504/355533001139501. 3551
70561139512/355533001139519. 355170561139538/355533001139535. 355170561139553/355533001139550. 355170561139587/355533001139584. 3
55170561139595/355533001139592. 355170561139603/355533001139600. 355170561139611/355533001139618. 355170561139629/355533001139626
. 355170561139637/355533001139634. 355170561139645/355533001139642. 355170561139652/355533001139659. 355170561139660/355533001139
667. 355170561139678/355533001139675. 355170561139686/355533001139683. 355170561139694/355533001139691. 355170561139710/355533001
139717. 355170561139736/355533001139733. 355170561139744/355533001139741. 355170561139751/355533001139758. 355170561139769/355533
001139766. 355170561139777/355533001139774. 355170561139785/355533001139782. 355170561139793/355533001139790. 355170561139801/355
533001139808. 355170561139819/355533001139816. 355170561139827/355533001139824. 355170561139835/355533001139832.355170561139843/3
55533001139840. 355170561139850/355533001139857. 355170561139868/355533001139865. 355170561139876/355533001139873. 35517056113988
4/355533001139881. 355170561139892/355533001139899. 355170561139900/355533001139907. 355170561139918/355533001139915. 35517056113
9926/355533001139923. 355170561139942/355533001139949. 355170561139959/355533001139956. 355170561139967/355533001139964. 35517056
1139975/355533001139972. 355170561139991/355533001139998. 355170561140007/355533001140004. 355170561140015/355533001140012. 35517
0561140064/355533001140061.355170561140098/355533001140095. 355170561140106/355533001140103. 355170561140114/355533001140111. 355
170561140122/355533001140129. 355170561140130/355533001140137. 355170561140148/355533001140145. 355170561140155/355533001140152.
355170561140163/355533001140160. 355170561140171/355533001140178. 355170561140189/355533001140186. 355170561140197/35553300114019
4. 355170561140205/355533001140202. 355170561140213/355533001140210. 355170561140221/355533001140228. 355170561140239/35553300114
0236. 355170561140247/355533001140244. 355170561140270/355533001140277. 355170561140288/355533001140285. 355170561140296/35553300
1140293. 355170561140304/355533001140301. 355170561140312/355533001140319. 355170561140320/355533001140327. 355170561140338/35553
3001140335. 355170561140353/355533001140350. 355170561140361/355533001140368. 355170561140379/355533001140376. 355170561140387/35
5533001140384. 355170561140395/355533001140392. 355170561140411/355533001140418. 355170561140429/355533001140426. 355170561140437
/355533001140434. 355170561140460/355533001140467. 355170561140478/355533001140475. 355170561140486/355533001140483. 355170561140
502/355533001140509. 355170561140510/355533001140517. 355170561140528/355533001140525. 355170561140536/355533001140533. 355170561
140551/355533001140558. 355170561140569/355533001140566. 355170561140577/355533001140574. 355170561140585/355533001140582. 355170
561140593/355533001140590. 355170561140619/355533001140616. 355170561140627/355533001140624. 355170561140635/355533001140632. 355
170561140643/355533001140640. 355170561140668/355533001140665. 355170561140676/355533001140673. 355170561140684/355533001140681.
355170561140700/355533001140707. 355170561140718/355533001140715. 355170561140726/355533001140723.355170561140734/355533001140731
. 355170561140742/355533001140749. 355170561140759/355533001140756. 355170561140767/355533001140764. 355170561140775/355533001140
772. 355170561140783/355533001140780. 355170561140791/355533001140798. 355170561140809/355533001140806. 355170561140817/355533001
140814. 355170561140825/355533001140822. 355170561140858/355533001140855. 355170561140882/355533001140889. 355170561140890/355533
001140897. 355170561140916/355533001140913. 355170561140932/355533001140939. 355170561140940/355533001140947. 355170561140957/355
533001140954.355170561140973/355533001140970. 355170561140999/355533001140996. 355170561141005/355533001141002. 355170561141054/3
55533001141051. 355170561141062/355533001141069. 355170561141070/355533001141077. 355170561141104/355533001141101. 35517056114111
2/355533001141119. 355170561141120/355533001141127. 355170561141138/355533001141135. 355170561141146/355533001141143. 35517056114
1161/355533001141168. 355170561141179/355533001141176. 355170561141187/355533001141184. 355170561141195/355533001141192. 35517056
1141203/355533001141200. 355170561141211/355533001141218. 355170561141229/355533001141226. 355170561141245/355533001141242. 35517
0561141252/355533001141259. 355170561141260/355533001141267. 355170561141278/355533001141275. 355170561141286/355533001141283. 35
5170561141294/355533001141291. 355170561141310/355533001141317XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001248152-9
Espacio para uso exclusivo de la Entidad Recaudadora
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