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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
032024001253783-6
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
102294385
30 . Apellidos y nombres
CARLOS ANDRES ROJAS MATAJUDIOS
31 . Clase
Importador
02
32 . Tipo declaración
Inicial
33 . Cod.
1
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. 116575014754601
43 . Año – Mes – Día
2024 – 09 – 09
44 . Documento de transporte
No. PVG71378305
45 . Año – Mes – Día
2024 – 09 – 02
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
6900296085
52 . Año – Mes – Día
2024 – 08 – 30
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.
4.172.50
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.
169.00
72 . Peso neto kgs. dcms.
137.50
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
500.00
78 .Valor FOB
USD
25.087.37
79 . Valor fletes USD
1.152.58 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
109.491.490
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
109.491.490
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
1.27
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.153.85
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
26.241.22
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: 530142-DECL: 1837580-DO: 893120589241- 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: 3072173645. ID CONTEN
EDOR: 6077830220. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A065MZKGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A06 DUOS (CON ACCESORIOS
PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, MODELO: SM-A065M/DS, USO O DESTINO: PARA LA VENTA AL MAYO(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
032024001253783
133. Feha: 202409 10
134 . Levante No. 032024001178385 135 . Fecha
2024 – 09 – 10
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 92032406730833
Fecha presentación 2024-09-10 17:28:25
Valor pagado $0.00
Fecha de Impresión: 2024-09-10 17:28:31
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001253783-6
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
R Y AL DETAL/ /MOBILE,SM-A065M/DS,BLACK,LTC( QTY. 500,00 u )(500,00 PCE); IMEIS: 354106701010974/357809261010972. 354106701010982
/357809261010980. 354106701010990/357809261010998. 354106701011006/357809261011004. 354106701011014/357809261011012. 354106701011
030/357809261011038. 354106701011048/357809261011046. 354106701011071/357809261011079. 354106701011097/357809261011095. 354106701
011105/357809261011103. 354106701011113/357809261011111. 354106701011139/357809261011137. 354106701011162/357809261011160. 354106
701011170/357809261011178. 354106701011204/357809261011202.354106701011253/357809261011251. 354106701011279/357809261011277. 3541
06701011287/357809261011285. 354106701011303/357809261011301. 354106701011311/357809261011319. 354106701011345/357809261011343. 3
54106701011352/357809261011350. 354106701011501/357809261011509. 354106701011618/357809261011616. 354106701011626/357809261011624
. 354106701011709/357809261011707. 354106701011980/357809261011988. 354106701012095/3578092 61012093. 354106701012129/35780926101
2127. 354106701012251/357809261012259. 354106701012301/357809261012309. 354106701012319/357809261012317. 354106701012327/35780926
1012325. 354106701012335/357809261012333. 354106701012384/357809261012382. 354106701012418/357809261012416. 354106701012475/35780
9261012473. 354106701012533/357809261012531. 354106701012673/357809261012671. 354106701012749/357809261012747. 354106701012798/35
7809261012796. 354106701012863/357809261012861. 354106701012905/357809261012903. 354106701012947/357809261012945. 354106701008861
/357809261008869. 354106701008879/357809261008877. 354106701008911/357809261008919. 354106701008952/357809261008950. 354106701008
960/357809261008968. 354106701008994/357809261008992. 354106701009042/357809261009040. 354106701009216/357809261009214. 354106701
009414/357809261009412. 354106701009661/357809261009669. 354106701009679/357809261009677. 354106701009703/357809261009701. 354106
701009737/357809261009735. 354106701009760/357809261009768. 354106701009786/357809261009784. 354106701009794/357809261009792. 354
106701009810/357809261009818. 354106701009828/357809261009826. 354106701009919/357809261009917. 354106701009943/357809261009941.
354106701010214/357809261010212. 354106701010297/357809261010295. 354106701010354/357809261010352. 354106701010370/35780926101037
8.354106701010396/357809261010394. 354106701010438/357809261010436. 354106701010495/357809261010493. 354106701010560/357809261010
568. 354106701010628/357809261010626. 354106701010636/357809261010634. 354106701010644/357809261010642. 354106701010669/357809261
010667. 354106701010685/357809261010683. 354106701010719/357809261010717. 354106701010735/357809261010733. 354106701010768/357809
261010766. 354106701010859/357809261010857. 354106701010867/357809261010865. 354106701010875/357809261010873. 354106701010909/357
809261010907. 354106701010917/357809261010915.354106701010925/357809261010923. 354106701010933/357809261010931. 354106701010941/3
57809261010949. 354106701010958/357809261010956. 354106701013044/357809261013042. 354106701013051/357809261013059. 35410670101312
7/357809261013125. 354106701013135/357809261013133. 354106701013168/357809261013166. 354106701013176/357809261013174. 35410670101
3200/357809261013208. 354106701013234/357809261013232. 354106701013275/357809261013273. 354106701013366/357809261013364. 35410670
1013390/357809261013398. 354106701013408/357809261013406. 354106701013416/357809261013414. 354106701013424/357809261013422. 35410
6701013481/357809261013489. 354106701013556/357809261013554. 354106701013580/357809261013588. 354106701013622/357809261013620. 35
4106701013630/357809261013638. 354106701013655/357809261013653. 354106701013663/357809261013661. 354106701013671/357809261013679.
354106701013689/357809261013687. 354106701013739/357809261013737. 354106701013754/357809261013752. 354106701013770/3578092610137
78. 354106701013788/357809261013786. 354106701013796/357809261013794. 354106701013804/357809261013802. 354106701013820/3578092610
13828. 354106701013846/357809261013844. 354106701013861/357809261013869. 354106701013879/357809261013877. 354106701013887/3578092
61013885. 354106701013895/357809261013893. 354106701013903/357809261013901. 354106701013911/357809261013919. 354106701013937/3578
09261013935. 354106701013986/357809261013984. 354106701013994/357809261013992. 354106701014000/357809261014008. 354106701014018/3
57809261014016. 354106701014034/357809261014032. 354106701014059/357809261014057. 354106701014083/357809261014081. 35410670099948
2/357809260999480. 354106701000405/357809261000403. 354106701000538/357809261000536. 354106701000819/357809261000817.354106701000
934/357809261000932. 354106701001189/357809261001187. 354106701001478/357809261001476. 354106701001668/357809261001666. 354106701
001726/357809261001724. 354106701002484/357809261002482. 354106701002625/357809261002623. 354106701002633/357809261002631. 354106
701002732/357809261002730. 354106701004035/357809261004033. 354106701004068/357809261004066. 354106701004076/357809261004074. 354
106701004191/357809261004199. 354106701004266/357809261004264. 354106701004274/357809261004272. 354106701004308/357809261004306.
354106701004431/357809261004439.354106701004514/357809261004512. 354106701004670/357809261004678. 354106701004696/357809261004694
. 354106701005065/357809261005063. 354106701005081/357809261005089. 354106701005123/357809261005121. 354106701005610/357809261005
618. 354106701005842/357809261005840. 354106701006170/357809261006178. 354106701007707/357809261007705. 354106701007814/357809261
007812. 354106701007871/357809261007879. 354106701007988/357809261007986. 354106701008036/357809261008034. 354106701008044/357809
261008042. 354106701008184/357809261008182. 354106701008200/357809261008208. 354106701008523/357809261008521. 354106701008598/357
809261008596. 354106701008606/357809261008604. 354106701008655/357809261008653. 354106701008663/357809261008661. 354106701008747/
357809261008745. 354106701014091/357809261014099. 354106701014109/357809261014107. 354106701014125/357809261014123. 3541067010141
33/357809261014131. 354106701014141/357809261014149. 354106701014158/357809261014156. 354106701014166/357809261014164. 3541067010
14174/357809261014172. 354106701014182/357809261014180. 354106701014190/357809261014198. 354106701014224/357809261014222. 3541067
01014273/357809261014271. 354106701014299/357809261014297. 354106701014307/357809261014305. 354106701014331/357809261014339. 3541
06701014349/357809261014347. 354106701014356/357809261014354. 354106701014364/357809261014362. 354106701014372/357809261014370. 3
54106701014380/357809261014388. 354106701014406/357809261014404. 354106701014414/357809261014412. 354106701014422/357809261014420
. 354106701014430/357809261014438. 354106701014448/357809261014446. 354106701014455/357809261014453. 354106701014463/357809261014
461. 354106701014471/357809261014479. 354106701014489/357809261014487. 354106701014497/357809261014495.354106701014505/3578092610
14503. 354106701014513/357809261014511. 354106701014521/357809261014529. 354106701014547/357809261014545. 354106701014554/3578092
61014552. 354106701014562/357809261014560. 354106701014570/357809261014578. 354106701014588/357809261014586. 354106701014612/3578
09261014610. 354106701014620/357809261014628. 354106701014638/357809261014636. 354106701014646/357809261014644. 354106701014653/3
57809261014651. 354106701014661/357809261014669. 354106701014687/357809261014685. 354106701014703/357809261014701. 35410670101471
1/357809261014719.354106701014729/357809261014727. 354106701014745/357809261014743. 354106701014760/357809261014768. 354106701014
778/357809261014776. 354106701014786/357809261014784. 354106701014794/357809261014792. 354106701014802/357809261014800. 354106701
014810/357809261014818. 354106701014828/357809261014826. 354106701014836/357809261014834. 354106701014844/357809261014842. 354106
701014851/357809261014859. 354106701014885/357809261014883. 354106701014893/357809261014891. 354106701014927/357809261014925. 354
106701014943/357809261014941. 354106701014950/357809261014958. 354106701014968/357809261014966. 354106701014992/357809261014990.
354106701015007/357809261015005. 354106701015015/357809261015013. 354106701015023/357809261015021. 354106701015031/35780926101503
9. 354106701015049/357809261015047. 354106701015056/357809261015054. 354106701015114/357809261015112. 354106701015155/35780926101
5153. 354106701015189/357809261015187. 354106701015197/357809261015195. 354106701015205/357809261015203. 354106701015213/35780926
1015211. 354106701015239/357809261015237. 354106701015262/357809261015260. 354106701015270/357809261015278. 354106701015288/35780
9261015286. 354106701015379/357809261015377. 354106701015429/357809261015427. 354106701015437/357809261015435. 354106701015445/35
7809261015443. 354106701015452/357809261015450. 354106701015478/357809261015476. 354106701015494/357809261015492. 354106701015544
/357809261015542. 354106701015569/357809261015567. 354106701015585/357809261015583. 354106701015627/357809261015625. 354106701015
635/357809261015633. 354106701015643/357809261015641. 354106701015692/357809261015690. 354106701016047/357809261016045. 354106701
016070/357809261016078. 354106701016096/357809261016094. 354106701016914/357809261016912.354106701017045/357809261017043. 3541067
01017136/357809261017134. 354106701017235/357809261017233. 354106701017250/357809261017258. 354106701017276/357809261017274. 3541
06701017292/357809261017290. 354106701017326/357809261017324. 354106701017334/357809261017332. 354106701017375/357809261017373. 3
54106701017383/357809261017381. 354106701017391/357809261017399. 354106701017409/357809261017407. 354106701017417/357809261017415
032024001253783-6
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001253783-6
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
. 354106701017433/357809261017431. 354106701017441/357809261017449. 354106701017458/357809261017456. 354106701017466/357809261017
464.354106701017508/357809261017506. 354106701017607/357809261017605. 354106701017649/357809261017647. 354106701017656/3578092610
17654. 354106701017664/357809261017662. 354106701017714/357809261017712. 354106701017755/357809261017753. 354106701017771/3578092
61017779. 354106701017797/357809261017795. 354106701017805/357809261017803. 354106701017839/357809261017837. 354106701017854/3578
09261017852. 354106701017862/357809261017860. 354106701017888/357809261017886. 354106701017896/357809261017894. 354106701017912/3
57809261017910. 354106701017938/357809261017936. 354106701017946/357809261017944. 354106701017961/357809261017969. 35410670101797
9/357809261017977. 354106701017987/357809261017985. 354106701017995/357809261017993. 354106701018001/357809261018009. 35410670101
8019/357809261018017. 354106701018035/357809261018033. 354106701018076/357809261018074. 354106701018084/357809261018082. 35410670
1018480/357809261018488. 354106701018506/357809261018504. 354106701018514/357809261018512. 354106701018613/357809261018611. 35410
6701018688/357809261018686. 354106701019272/357809261019270. 354106701019439/357809261019437. 354106701019652/357809261019650. 35
4106701019678/357809261019676. 354106701019777/357809261019775. 354106701020015/357809261020013. 354106701020130/357809261020138.
354106701020205/357809261020203. 354106701020338/357809261020336. 354106701020361/357809261020369. 354106701020379/3578092610203
77. 354106701020387/357809261020385. 354106701020395/357809261020393. 354106701020403/357809261020401. 354106701020411/3578092610
20419. 354106701020429/357809261020427. 354106701020437/357809261020435. 354106701020445/357809261020443. 354106701020452/3578092
61020450. 354106701020460/357809261020468. 354106701020478/357809261020476.354106701020486/357809261020484. 354106701020494/35780
9261020492. 354106701020502/357809261020500. 354106701020510/357809261020518. 354106701020544/357809261020542. 354106701020585/35
7809261020583. 354106701020593/357809261020591. 354106701020601/357809261020609. 354106701020643/357809261020641. 354106701020650
/357809261020658. 354106701020676/357809261020674. 354106701020684/357809261020682. 354106701020692/357809261020690. 354106701020
700/357809261020708. 354106701020718/357809261020716. 354106701020742/357809261020740. 354106701020759/357809261020757.3541067010
20767/357809261020765. 354106701020775/357809261020773. 354106701020783/357809261020781. 354106701020809/357809261020807. 3541067
01020817/357809261020815. 354106701020833/357809261020831. 354106701020858/357809261020856. 354106701020866/357809261020864. 3541
06701020874/357809261020872. 354106701020882/357809261020880. 354106701020890/357809261020898. 354106701020908/357809261020906. 3
54106701020916/357809261020914. 354106701020924/357809261020922. 354106701020932/357809261020930. 354106701020957/357809261020955
. 354106701020965/357809261020963. 354106701020999/357809261020997. 354106701021005/357809261021003. 354106701021039/357809261021
037. 354106701021047/357809261021045. 354106701021054/357809261021052. 354106701021062/357809261021060. 354106701021070/357809261
021078. 354106701021088/357809261021086. 354106701021096/357809261021094. 354106701021104/357809261021102. 354106701021138/357809
261021136. 354106701021153/357809261021151. 354106701021161/357809261021169. 354106701021179/357809261021177. 354106701021187/357
809261021185. 354106701021195/357809261021193. 354106701021203/357809261021201. 354106701021211/357809261021219. 354106701021229/
357809261021227. 354106701021237/357809261021235. 354106701021245/357809261021243. 354106701021260/357809261021268. 3541067010212
78/357809261021276. 354106701021286/357809261021284. 354106701021294/357809261021292. 354106701021302/357809261021300. 3541067010
21328/357809261021326. 354106701021344/357809261021342. 354106701021351/357809261021359. 354106701021369/357809261021367. 3541067
01021385/357809261021383. 354106701021393/357809261021391. 354106701021401/357809261021409. 354106701021419/357809261021417. 3541
06701021443/357809261021441. 354106701021450/357809261021458.354106701021468/357809261021466. 354106701021484/357809261021482. 35
4106701021500/357809261021508. 354106701021518/357809261021516. 354106701021526/357809261021524. 354106701021534/357809261021532.
354106701021542/357809261021540. 354106701021559/357809261021557. 354106701021567/357809261021565. 354106701021575/3578092610215
73. 354106701021583/357809261021581. 354106701021591/357809261021599. 354106701021609/357809261021607. 354106701021617/3578092610
21615. 354106701021625/357809261021623. 354106701021633/357809261021631. 354106701021641/357809261021649.354106701021658/35780926
1021656. 354106701021674/357809261021672. 354106701021682/357809261021680. 354106701021690/357809261021698. 354106701021708/35780
9261021706. 354106701021724/357809261021722. 354106701021740/357809261021748. 354106701021757/357809261021755. 354106701021765/35
7809261021763. 354106701021773/357809261021771. 354106701021781/357809261021789. 354106701021799/357809261021797. 354106701021807
/357809261021805. 354106701021815/357809261021813. 354106701021823/357809261021821. 354106701021831/357809261021839. 354106701021
849/357809261021847. 354106701021856/357809261021854. 354106701021864/357809261021862. 354106701021872/357809261021870. 354106701
021880/357809261021888. 354106701021898/357809261021896. 354106701021906/357809261021904. 354106701021922/357809261021920. 354106
701021955/357809261021953. 354106701021963/357809261021961. 354106701021971/357809261021979. 354106701021989/357809261021987. 354
106701022003/357809261022001. 354106701022011/357809261022019. 354106701022037/357809261022035. 354106701022045/357809261022043.
354106701022060/357809261022068. 354106701022094/357809261022092. 354106701022110/357809261022118. 354106701022128/35780926102212
6. 354106701022136/357809261022134. 354106701022151/357809261022159. 354106701022177/357809261022175. 354106701022193/35780926102
2191. 354106701022201/357809261022209. 354106701022219/357809261022217. 354106701022227/357809261022225. 354106701022235/35780926
1022233. 354106701022243/357809261022241. 354106701022250/357809261022258. 354106701022276/357809261022274. 354106701022284/35780
9261022282. 354106701022292/357809261022290. 354106701022318/357809261022316. 354106701022326/357809261022324. 354106701022342/35
7809261022340. 354106701022375/357809261022373.354106701022383/357809261022381. 354106701022391/357809261022399. 354106701022508/
357809261022506. 354106701022516/357809261022514. 354106701022573/357809261022571. 354106701022581/357809261022589. 3541067010226
31/357809261022639. 354106701022789/357809261022787. 354106701023936/357809261023934. 354106701024041/357809261024049. 3541067010
24405/357809261024403. 354106701024462/357809261024460XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001253783-6
Espacio para uso exclusivo de la Entidad Recaudadora
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