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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
032024001269483-1
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
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. 116575014777721
43 . Año – Mes – Día
2024 – 09 – 15
44 . Documento de transporte
No. HKG0364323
45 . Año – Mes – Día
2024 – 09 – 08
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
6900296196
52 . Año – Mes – Día
2024 – 09 – 02
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
249
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
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.
172.00
72 . Peso neto kgs. dcms.
132.00
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
34.760.51
79 . Valor fletes USD
1.143.80 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
149.817.994
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
149.817.994
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
1.74
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.145.54
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
35.906.05
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: 530556-DECL: 1838509-DO: 893121202241- 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: 3072680945. ID CONTENEDOR: 6077886370. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A057MZSHLTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A05s DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, (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
032024001269483
133. Feha: 202409 12
134 . Levante No. 032024001205354 135 . Fecha
2024 – 09 – 16
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 92032406814808
Fecha presentación 2024-09-12 20:23:06
Valor pagado $0.00
Fecha de Impresión: 2024-09-16 14:29:49
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001269483-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MODELO: SM-A057M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A057M/DS,SILVER,LTC( QTY. 500,00 u )(500,00 PC
E); IMEIS: 350290618215548/355253228215543. 350290618215563/355253228215568. 350290618215571/355253228215576. 350290618215597/355
253228215592. 350290618215605/355253228215600. 350290618215621/355253228215626. 350290618215639/355253228215634. 350290618215647/
355253228215642. 350290618215654/355253228215659. 350290618215670/355253228215675. 350290618215688/355253228215683. 3502906182156
96/355253228215691. 350290618215720/355253228215725. 350290618215753/355253228215758. 350290618215761/355253228215766. 3502906182
15779/355253228215774. 350290618215795/355253228215790. 350290618215803/355253228215808. 350290618215811/355253228215816. 3502906
18215829/355253228215824. 350290618215837/355253228215832. 350290618215845/355253228215840. 350290618215852/355253228215857. 3502
90618215860/355253228215865. 350290618215878/355253228215873. 350290618215894/35525322821589 9. 350290618215902/355253228215907.
350290618215928/355253228215923. 350290618215936/355253228215931. 350290618215944/355253228215949. 350290618216017/35525322821601
2. 350290618216033/355253228216038. 350290618216066/355253228216061. 350290618216090/355253228216095. 350290618216157/35525322821
6152. 350290618216165/355253228216160. 350290618216173/355253228216178. 350290618216181/355253228216186. 350290618216199/35525322
8216194. 350290618216207/355253228216202. 350290618216215/355253228216210. 350290618216223/355253228216228. 350290618216231/35525
3228216236. 350290618216249/355253228216244. 350290618216256/355253228216251.350290618216264/355253228216269. 350290618216272/355
253228216277. 350290618216280/355253228216285. 350290618218948/355253228218943. 350290618218955/355253228218950. 350290618218989/
355253228218984. 350290618219003/355253228219008. 350290618219102/355253228219107. 350290618219185/355253228219180. 3502906182192
19/355253228219214. 350290618219227/355253228219222. 350290618219243/355253228219248. 350290618219276/355253228219271. 3502906182
19284/355253228219289. 350290618219573/355253228219578. 350290618219847/355253228219842. 350290618220001/355253228220006.35029061
8220043/355253228220048. 350290618220092/355253228220097. 350290618220142/355253228220147. 350290618220175/355253228220170. 35029
0618220183/355253228220188. 350290618220191/355253228220196. 350290618220209/355253228220204. 350290618220225/355253228220220. 35
0290618220258/355253228220253. 350290618220266/355253228220261. 350290618220274/355253228220279. 350290618220282/355253228220287.
350290618220290/355253228220295. 350290618220316/355253228220311. 350290618220399/355253228220394. 350290618220639/3552532282206
34. 350290618220688/355253228220683. 350290618220696/355253228220691. 350290618220704/355253228220709. 350290618220712/3552532282
20717. 350290618220787/355253228220782. 350290618220803/355253228220808. 350290618220829/355253228220824. 350290618220837/3552532
28220832. 350290618220845/355253228220840. 350290618220852/355253228220857. 350290618220860/355253228220865. 350290618220878/3552
53228220873. 350290618220894/355253228220899. 350290618220910/355253228220915. 350290618220928/355253228220923. 350290618220944/3
55253228220949. 350290618220951/355253228220956. 350290618220969/355253228220964. 350290618221017/355253228221012. 35029061822113
2/355253228221137. 350290618221181/355253228221186. 350290618221538/355253228221533. 350290618221561/355253228221566. 35029061822
1637/355253228221632. 350290618221710/355253228221715. 350290618221736/355253228221731. 350290618221744/355253228221749. 35029061
8221835/355253228221830. 350290618221868/355253228221863. 350290618222064/355253228222069. 350290618222098/355253228222093. 35029
0618222106/355253228222101. 350290618222155/355253228222150. 350290618222163/355253228222168. 350290618222189/355253228222184. 35
0290618222429/355253228222424. 350290618222692/355253228222697.350290618222700/355253228222705. 350290618222718/355253228222713.
350290618222726/355253228222721. 350290618222734/355253228222739. 350290618222767/355253228222762. 350290618222775/35525322822277
0. 350290618222783/355253228222788. 350290618222817/355253228222812. 350290618222825/355253228222820. 350290618222833/35525322822
2838. 350290618222841/355253228222846. 350290618222858/355253228222853. 350290618222874/355253228222879. 350290618222890/35525322
8222895. 350290618222908/355253228222903. 350290618222924/355253228222929. 350290618222932/355253228222937.350290618222940/355253
228222945. 350290618222965/355253228222960. 350290618222973/355253228222978. 350290618223005/355253228223000. 350290618223021/355
253228223026. 350290618223187/355253228223182. 350290618223229/355253228223224. 350290618223245/355253228223240. 350290618223252/
355253228223257. 350290618223302/355253228223307. 350290618223328/355253228223323. 350290618223351/355253228223356. 3502906182233
69/355253228223364. 350290618223377/355253228223372. 350290618223385/355253228223380. 350290618223393/355253228223398. 3502906182
23401/355253228223406. 350290618223419/355253228223414. 350290618223427/355253228223422. 350290618223435/355253228223430. 3502906
18223443/355253228223448. 350290618223484/355253228223489. 350290618223492/355253228223497. 350290618223500/355253228223505. 3502
90618223518/355253228223513. 350290618223526/355253228223521. 350290618223534/355253228223539. 350290618223559/355253228223554. 3
50290618223567/355253228223562. 350290618223575/355253228223570. 350290618223625/355253228223620. 350290618223658/355253228223653
. 350290618223682/355253228223687. 350290618223690/355253228223695. 350290618223716/355253228223711. 350290618223732/355253228223
737. 350290618223740/355253228223745. 350290618223757/355253228223752. 350290618223765/355253228223760. 350290618223773/355253228
223778. 350290618223781/355253228223786. 350290618223799/355253228223794. 350290618223849/355253228223844. 350290618223872/355253
228223877. 350290618223880/355253228223885. 350290618223898/355253228223893. 350290618224011/355253228224016. 350290618224029/355
253228224024. 350290618224045/355253228224040. 350290618224060/355253228224065. 350290618224094/355253228224099. 350290618224102/
355253228224107. 350290618224128/355253228224123.350290618224136/355253228224131. 350290618224151/355253228224156. 35029061822416
9/355253228224164. 350290618224185/355253228224180. 350290618224219/355253228224214. 350290618224227/355253228224222. 35029061822
4235/355253228224230. 350290618224243/355253228224248. 350290618224250/355253228224255. 350290618224268/355253228224263. 35029061
8224276/355253228224271. 350290618224292/355253228224297. 350290618224318/355253228224313. 350290618224326/355253228224321. 35029
0618224359/355253228224354. 350290618224367/355253228224362. 350290618224375/355253228224370.350290618224383/355253228224388. 350
290618224409/355253228224404. 350290618224425/355253228224420. 350290618224433/355253228224438. 350290618224441/355253228224446.
350290618224482/355253228224487. 350290618224490/355253228224495. 350290618224508/355253228224503. 350290618224516/35525322822451
1. 350290618224540/355253228224545. 350290618224557/355253228224552. 350290618224565/355253228224560. 350290618224599/35525322822
4594. 350290618224607/355253228224602. 350290618224615/355253228224610. 350290618224623/355253228224628. 350290618224649/35525322
8224644. 350290618224656/355253228224651. 350290618224664/355253228224669. 350290618224680/355253228224685. 350290618224698/35525
3228224693. 350290618224714/355253228224719. 350290618224862/355253228224867. 350290618226370/355253228226375. 350290618227535/35
5253228227530. 350290618227741/355253228227746. 350290618227774/355253228227779. 350290618227964/355253228227969. 350290618227972
/355253228227977. 350290618228020/355253228228025. 350290618228111/355253228228116. 350290618228442/355253228228447. 350290618228
988/355253228228983. 350290618229119/355253228229114. 350290618229135/355253228229130. 350290618229143/355253228229148. 350290618
229168/355253228229163. 350290618229283/355253228229288. 350290618229333/355253228229338. 350290618229341/355253228229346. 350290
618229374/355253228229379. 350290618229382/355253228229387. 350290618229390/355253228229395. 350290618229408/355253228229403. 350
290618229432/355253228229437. 350290618229457/355253228229452. 350290618229515/355253228229510. 350290618229523/355253228229528.
350290618229572/355253228229577. 350290618229606/355253228229601. 350290618229614/355253228229619. 350290618229937/35525322822993
2. 350290618230042/355253228230047.350290618230059/355253228230054. 350290618230489/355253228230484. 350290618230562/355253228230
567. 350290618230653/355253228230658. 350290618230760/355253228230765. 350290618230802/355253228230807. 350290618231172/355253228
231177. 350290618231214/355253228231219. 350290618231222/355253228231227. 350290618231271/355253228231276. 350290618231289/355253
228231284. 350290618231297/355253228231292. 350290618231313/355253228231318. 350290618231321/355253228231326. 350290618231354/355
253228231359. 350290618231396/355253228231391. 350290618231412/355253228231417.350290618231420/355253228231425. 350290618231453/3
55253228231458. 350290618231461/355253228231466. 350290618203965/355253228203960. 350290618203999/355253228203994. 35029061820401
3/355253228204018. 350290618204021/355253228204026. 350290618204039/355253228204034. 350290618204047/355253228204042. 35029061820
4062/355253228204067. 350290618204070/355253228204075. 350290618204096/355253228204091. 350290618204104/355253228204109. 35029061
8204112/355253228204117. 350290618204120/355253228204125. 350290618204138/355253228204133. 350290618204146/355253228204141. 35029
032024001269483-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001269483-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
0618204153/355253228204158. 350290618204161/355253228204166. 350290618204179/355253228204174. 350290618204187/355253228204182. 35
0290618204195/355253228204190. 350290618204211/355253228204216. 350290618204229/355253228204224. 350290618204245/355253228204240.
350290618204252/355253228204257. 350290618204260/355253228204265. 350290618204286/355253228204281. 350290618204294/3552532282042
99. 350290618204302/355253228204307. 350290618204310/355253228204315. 350290618204328/355253228204323. 350290618204336/3552532282
04331. 350290618204344/355253228204349. 350290618204377/355253228204372. 350290618204385/355253228204380. 350290618204393/3552532
28204398. 350290618204419/355253228204414. 350290618204435/355253228204430. 350290618204443/355253228204448. 350290618204450/3552
53228204455. 350290618204468/355253228204463. 350290618204476/355253228204471. 350290618204484/355253228204489. 350290618204492/3
55253228204497. 350290618204518/355253228204513. 350290618204559/355253228204554. 350290618204567/355253228204562. 35029061820457
5/355253228204570. 350290618204583/355253228204588. 350290618204591/355253228204596. 350290618204609/355253228204604. 35029061820
4617/355253228204612.350290618204625/355253228204620. 350290618204633/355253228204638. 350290618204641/355253228204646. 350290618
204658/355253228204653. 350290618204666/355253228204661. 350290618204674/355253228204679. 350290618204682/355253228204687. 350290
618204690/355253228204695. 350290618204708/355253228204703. 350290618204716/355253228204711. 350290618204732/355253228204737. 350
290618204740/355253228204745. 350290618204781/355253228204786. 350290618204799/355253228204794. 350290618204807/355253228204802.
350290618204864/355253228204869. 350290618204922/355253228204927.350290618204989/355253228204984. 350290618204997/355253228204992
. 350290618205002/355253228205007. 350290618205010/355253228205015. 350290618205978/355253228205973. 350290618207016/355253228207
011. 350290618207743/355253228207748. 350290618207768/355253228207763. 350290618207776/355253228207771. 350290618207800/355253228
207805. 350290618207818/355253228207813. 350290618207826/355253228207821. 350290618207958/355253228207953. 350290618207966/355253
228207961. 350290618207982/355253228207987. 350290618208030/355253228208035. 350290618208063/355253228208068. 350290618208139/355
253228208134. 350290618208188/355253228208183. 350290618208246/355253228208241. 350290618208253/355253228208258. 350290618208261/
355253228208266. 350290618208287/355253228208282. 350290618208295/355253228208290. 350290618208337/355253228208332. 3502906182087
82/355253228208787. 350290618208840/355253228208845. 350290618208931/355253228208936. 350290618208972/355253228208977. 3502906182
09004/355253228209009. 350290618209095/355253228209090. 350290618209319/355253228209314. 350290618209368/355253228209363. 3502906
18209459/355253228209454. 350290618209509/355253228209504. 350290618209525/355253228209520. 350290618209541/355253228209546. 3502
90618209558/355253228209553. 350290618209566/355253228209561. 350290618209574/355253228209579. 350290618209582/355253228209587. 3
50290618210457/355253228210452. 350290618210499/355253228210494. 350290618210531/355253228210536. 350290618210572/355253228210577
. 350290618210614/355253228210619. 350290618210648/355253228210643. 350290618210655/355253228210650. 350290618210721/355253228210
726. 350290618210739/355253228210734. 350290618210754/355253228210759. 350290618210853/355253228210858. 350290618210895/355253228
210890.350290618210929/355253228210924. 350290618210945/355253228210940. 350290618210952/355253228210957. 350290618211323/3552532
28211328. 350290618212040/355253228212045. 350290618212057/355253228212052. 350290618212073/355253228212078. 350290618212081/3552
53228212086. 350290618212099/355253228212094. 350290618212107/355253228212102. 350290618212131/355253228212136. 350290618212156/3
55253228212151. 350290618212164/355253228212169. 350290618212172/355253228212177. 350290618212180/355253228212185. 35029061821219
8/355253228212193. 350290618212404/355253228212409.350290618212867/355253228212862. 350290618212891/355253228212896. 350290618212
925/355253228212920. 350290618212941/355253228212946. 350290618212958/355253228212953. 350290618213014/355253228213019. 350290618
213105/355253228213100. 350290618213196/355253228213191. 350290618213220/355253228213225. 350290618213238/355253228213233. 350290
618213287/355253228213282. 350290618213329/355253228213324. 350290618213402/355253228213407. 350290618213444/355253228213449. 350
290618213618/355253228213613. 350290618213626/355253228213621. 350290618213741/355253228213746. 350290618213840/355253228213845.
350290618213865/355253228213860. 350290618213873/355253228213878. 350290618213907/355253228213902. 350290618213915/35525322821391
0. 350290618213931/355253228213936. 350290618213949/355253228213944. 350290618213956/355253228213951. 350290618214129/35525322821
4124. 350290618214145/355253228214140. 350290618214160/355253228214165. 350290618214178/355253228214173. 350290618214350/35525322
8214355. 350290618214376/355253228214371. 350290618214566/355253228214561. 350290618214590/355253228214595. 350290618214624/35525
3228214629. 350290618214632/355253228214637. 350290618214673/355253228214678. 350290618214681/355253228214686. 350290618214715/35
5253228214710. 350290618214731/355253228214736. 350290618214749/355253228214744. 350290618214756/355253228214751. 350290618214830
/355253228214835. 350290618214848/355253228214843. 350290618214855/355253228214850. 350290618214863/355253228214868. 350290618214
871/355253228214876. 350290618214889/355253228214884. 350290618214897/355253228214892. 350290618214913/355253228214918. 350290618
214921/355253228214926. 350290618214939/355253228214934. 350290618214947/355253228214942. 350290618214954/355253228214959.3502906
18214962/355253228214967. 350290618214970/355253228214975. 350290618214988/355253228214983. 350290618214996/355253228214991. 3502
90618215019/355253228215014. 350290618215027/355253228215022. 350290618215043/355253228215048. 350290618215050/355253228215055. 3
50290618215068/355253228215063. 350290618215076/355253228215071. 350290618215092/355253228215097. 350290618215100/355253228215105
. 350290618215118/355253228215113. 350290618215134/355253228215139. 350290618215159/355253228215154. 350290618215167/355253228215
162. 350290618215175/355253228215170.350290618215183/355253228215188. 350290618215191/355253228215196. 350290618215209/3552532282
15204. 350290618215241/355253228215246. 350290618215258/355253228215253. 350290618215274/355253228215279. 350290618215308/3552532
28215303. 350290618215316/355253228215311. 350290618215324/355253228215329. 350290618215357/355253228215352. 350290618215373/3552
53228215378. 350290618215415/355253228215410. 350290618215449/355253228215444. 350290618215464/355253228215469. 350290618215480/3
55253228215485. 350290618215506/355253228215501. 350290618215522/355253228215527. 350290618215530/355253228215535XXXXXXXXXXXXXXXX
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032024001269483-1
Espacio para uso exclusivo de la Entidad Recaudadora
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