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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
032024001327912-9
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. 116575014834420
43 . Año – Mes – Día
2024 – 10 – 01
44 . Documento de transporte
No. KHAN24096475
45 . Año – Mes – Día
2024 – 09 – 22
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
9102899895
52 . Año – Mes – Día
2024 – 09 – 22
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
249
56 . Cod. Depto
destino
0
57 . Empresa transportadora
DHL AERO EXPRESO S A SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.175.10
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
855
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.
144.00
72 . Peso neto kgs. dcms.
112.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
400.00
78 .Valor FOB
USD
69.260.88
79 . Valor fletes USD
1.032.48 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
293.496.003
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
293.496.003
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
3.40
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.035.88
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
70.296.76
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: 531885-DECL: 1842085-DO: 893122632241- 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: 3074398744. ID CONTENEDOR: 6078120325. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A356EZKGLTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A35 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO(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
032024001327912
133. Feha: 202409 24
134 . Levante No. 032024001287194 135 . Fecha
2024 – 10 – 02
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 92032407117526
Fecha presentación 2024-09-24 15:50:26
Valor pagado $0.00
Fecha de Impresión: 2024-10-02 12:55:33
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001327912-9
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
, MODELO: SM-A356E/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A356E/DS,BLACK,LTC( QTY. 400,00 u )(400,00 PC
E); IMEIS: 351676564354415/357896814354411. 351676564354423/357896814354429. 351676564354431/357896814354437. 351676564354456/357
896814354452. 351676564354472/357896814354478. 351676564354480/357896814354486. 351676564354548/357896814354544. 351676564354555/
357896814354551. 351676564354613/357896814354619. 351676564354639/357896814354635. 351676564354704/357896814354700. 3516765643547
12/357896814354718. 351676564354779/357896814354775. 351676564354811/357896814354817. 351676564354837/357896814354833. 3516765643
54993/357896814354999. 351676564355024/357896814355020. 351676564355040/357896814355046. 351676564355057/357896814355053. 3516765
64355107/357896814355103. 351676564355123/357896814355129. 351676564355172/357896814355178. 351676564355222/357896814355228. 3516
76564355230/357896814355236. 351676564355255/357896814355251. 351676564355271/35789681435527 7. 351676564355289/357896814355285.
351676564355321/357896814355327. 351676564355347/357896814355343. 351676564355370/357896814355376. 351676564355388/35789681435538
4. 351676564355412/357896814355418. 351676564355503/357896814355509. 351676564355511/357896814355517. 351676564355529/35789681435
5525. 351676564355537/357896814355533. 351676564355545/357896814355541. 351676564355552/357896814355558. 351676564355578/35789681
4355574. 351676564355628/357896814355624. 351676564355636/357896814355632. 351676564355651/357896814355657. 351676564355669/35789
6814355665. 351676564355685/357896814355681. 351676564355727/357896814355723.351676564356030/357896814356036. 351676564356121/357
896814356127. 351676564356212/357896814356218. 351676564356337/357896814356333. 351676564356352/357896814356358. 351676564356428/
357896814356424. 351676564356626/357896814356622. 351676564356899/357896814356895. 351676564356923/357896814356929. 3516765643570
61/357896814357067. 351676564357103/357896814357109. 351676564357129/357896814357125. 351676564357160/357896814357166. 3516765643
57178/357896814357174. 351676564357186/357896814357182. 351676564357194/357896814357190. 351676564357202/357896814357208.35167656
4357434/357896814357430. 351676564357459/357896814357455. 351676564357483/357896814357489. 351676564357509/357896814357505. 35167
6564357541/357896814357547. 351676564357590/357896814357596. 351676564357608/357896814357604. 351676564357616/357896814357612. 35
1676564357657/357896814357653. 351676564357665/357896814357661. 351676564357673/357896814357679. 351676564357699/357896814357695.
351676564357707/357896814357703. 351676564357715/357896814357711. 351676564357723/357896814357729. 351676564357749/3578968143577
45. 351676564372607/357896814372603. 351676564372656/357896814372652. 351676564372664/357896814372660. 351676564372672/3578968143
72678. 351676564372680/357896814372686. 351676564372714/357896814372710. 351676564372722/357896814372728. 351676564372730/3578968
14372736. 351676564372748/357896814372744. 351676564372755/357896814372751. 351676564372763/357896814372769. 351676564372771/3578
96814372777. 351676564372789/357896814372785. 351676564372797/357896814372793. 351676564372805/357896814372801. 351676564372870/3
57896814372876. 351676564372912/357896814372918. 351676564372920/357896814372926. 351676564372946/357896814372942. 35167656437295
3/357896814372959. 351676564372995/357896814372991. 351676564373001/357896814373007. 351676564373019/357896814373015. 35167656437
3035/357896814373031. 351676564373043/357896814373049. 351676564373050/357896814373056. 351676564373068/357896814373064. 35167656
4373076/357896814373072. 351676564373100/357896814373106. 351676564373134/357896814373130. 351676564373167/357896814373163. 35167
6564373183/357896814373189. 351676564373191/357896814373197. 351676564373399/357896814373395. 351676564373407/357896814373403. 35
1676564373480/357896814373486. 351676564373506/357896814373502.351676564373514/357896814373510. 351676564373530/357896814373536.
351676564373555/357896814373551. 351676564374017/357896814374013. 351676564374033/357896814374039. 351676564374082/35789681437408
8. 351676564374090/357896814374096. 351676564374116/357896814374112. 351676564374140/357896814374146. 351676564374165/35789681437
4161. 351676564374173/357896814374179. 351676564374181/357896814374187. 351676564374199/357896814374195. 351676564374207/35789681
4374203. 351676564374215/357896814374211. 351676564374223/357896814374229. 351676564374231/357896814374237.351676564374264/357896
814374260. 351676564374348/357896814374344. 351676564376459/357896814376455. 351676564376483/357896814376489. 351676564255273/357
896814255279. 351676564255281/357896814255287. 351676564255299/357896814255295. 351676564255315/357896814255311. 351676564255372/
357896814255378. 351676564255844/357896814255840. 351676564256065/357896814256061. 351676564257899/357896814257895. 3516765642581
11/357896814258117. 351676564258145/357896814258141. 351676564258160/357896814258166. 351676564258186/357896814258182. 3516765642
58194/357896814258190. 351676564258210/357896814258216. 351676564258228/357896814258224. 351676564258236/357896814258232. 3516765
64258244/357896814258240. 351676564258251/357896814258257. 351676564258269/357896814258265. 351676564258277/357896814258273. 3516
76564258285/357896814258281. 351676564258293/357896814258299. 351676564258301/357896814258307. 351676564258319/357896814258315. 3
51676564258327/357896814258323. 351676564258335/357896814258331. 351676564258350/357896814258356. 351676564258368/357896814258364
. 351676564258376/357896814258372. 351676564258384/357896814258380. 351676564258400/357896814258406. 351676564258848/357896814258
844. 351676564259507/357896814259503. 351676564259515/357896814259511. 351676564259531/357896814259537. 351676564259564/357896814
259560. 351676564259572/357896814259578. 351676564259614/357896814259610. 351676564259630/357896814259636. 351676564259820/357896
814259826. 351676564259937/357896814259933. 351676564259945/357896814259941. 351676564259960/357896814259966. 351676564259978/357
896814259974. 351676564259986/357896814259982. 351676564260026/357896814260022. 351676564260414/357896814260410. 351676564260786/
357896814260782. 351676564260984/357896814260980.351676564261057/357896814261053. 351676564261065/357896814261061. 35167656426107
3/357896814261079. 351676564261081/357896814261087. 351676564261107/357896814261103. 351676564261172/357896814261178. 35167656426
1206/357896814261202. 351676564261214/357896814261210. 351676564261248/357896814261244. 351676564261271/357896814261277. 35167656
4261289/357896814261285. 351676564261305/357896814261301. 351676564261313/357896814261319. 351676564261339/357896814261335. 35167
6564261370/357896814261376. 351676564261388/357896814261384. 351676564261404/357896814261400.351676564261776/357896814261772. 351
676564261792/357896814261798. 351676564261818/357896814261814. 351676564261842/357896814261848. 351676564261859/357896814261855.
351676564261883/357896814261889. 351676564261917/357896814261913. 351676564261933/357896814261939. 351676564264515/35789681426451
1. 351676564264622/357896814264628. 351676564264655/357896814264651. 351676564264697/357896814264693. 351676564264747/35789681426
4743. 351676564266148/357896814266144. 351676564266155/357896814266151. 351676564266163/357896814266169. 351676564266171/35789681
4266177. 351676564266189/357896814266185. 351676564266205/357896814266201. 351676564266254/357896814266250. 351676564266288/35789
6814266284. 351676564266395/357896814266391. 351676564268870/357896814268876. 351676564269407/357896814269403. 351676564269449/35
7896814269445. 351676564269522/357896814269528. 351676564269548/357896814269544. 351676564269571/357896814269577. 351676564269621
/357896814269627. 351676564269647/357896814269643. 351676564269761/357896814269767. 351676564269936/357896814269932. 351676564270
033/357896814270039. 351676564270249/357896814270245. 351676564271601/357896814271607. 351676564272021/357896814272027. 351676564
341974/357896814341970. 351676564342295/357896814342291. 351676564342329/357896814342325. 351676564342360/357896814342366. 351676
564342378/357896814342374. 351676564342410/357896814342416. 351676564342568/357896814342564. 351676564342576/357896814342572. 351
676564342584/357896814342580. 351676564342592/357896814342598. 351676564342626/357896814342622. 351676564342642/357896814342648.
351676564342667/357896814342663. 351676564342675/357896814342671. 351676564342683/357896814342689. 351676564342741/35789681434274
7. 351676564342766/357896814342762.351676564342790/357896814342796. 351676564342857/357896814342853. 351676564342881/357896814342
887. 351676564342956/357896814342952. 351676564342980/357896814342986. 351676564342998/357896814342994. 351676564343020/357896814
343026. 351676564343038/357896814343034. 351676564343046/357896814343042. 351676564343053/357896814343059. 351676564343061/357896
814343067. 351676564343087/357896814343083. 351676564343111/357896814343117. 351676564343137/357896814343133. 351676564343145/357
896814343141. 351676564343152/357896814343158. 351676564343202/357896814343208.351676564343210/357896814343216. 351676564343228/3
57896814343224. 351676564343236/357896814343232. 351676564343244/357896814343240. 351676564343251/357896814343257. 35167656434332
7/357896814343323. 351676564343343/357896814343349. 351676564343384/357896814343380. 351676564343434/357896814343430. 35167656434
4341/357896814344347. 351676564344366/357896814344362. 351676564344374/357896814344370. 351676564344382/357896814344388. 35167656
4344416/357896814344412. 351676564344432/357896814344438. 351676564344457/357896814344453. 351676564344465/357896814344461. 35167
032024001327912-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001327912-9
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
6564344473/357896814344479. 351676564344507/357896814344503. 351676564344515/357896814344511. 351676564344523/357896814344529. 35
1676564344564/357896814344560. 351676564344572/357896814344578. 351676564344580/357896814344586. 351676564344606/357896814344602.
351676564344622/357896814344628. 351676564344911/357896814344917. 351676564345272/357896814345278. 351676564345322/3578968143453
28. 351676564345371/357896814345377. 351676564345389/357896814345385. 351676564345397/357896814345393. 351676564345405/3578968143
45401. 351676564345413/357896814345419. 351676564345439/357896814345435. 351676564345462/357896814345468. 351676564345496/3578968
14345492. 351676564345512/357896814345518. 351676564345538/357896814345534. 351676564345546/357896814345542. 351676564345561/3578
96814345567. 351676564345587/357896814345583. 351676564345603/357896814345609. 351676564345629/357896814345625. 351676564345694/3
57896814345690. 351676564345702/357896814345708. 351676564345777/357896814345773. 351676564345835/357896814345831. 35167656434607
2/357896814346078. 351676564346098/357896814346094. 351676564346106/357896814346102. 351676564346114/357896814346110. 35167656434
6122/357896814346128.351676564346130/357896814346136. 351676564346148/357896814346144. 351676564346163/357896814346169. 351676564
346197/357896814346193. 351676564346205/357896814346201. 351676564346239/357896814346235. 351676564346247/357896814346243. 351676
564346254/357896814346250. 351676564346262/357896814346268. 351676564346304/357896814346300. 351676564346320/357896814346326. 351
676564346346/357896814346342. 351676564346353/357896814346359. 351676564346379/357896814346375. 351676564346403/357896814346409.
351676564346429/357896814346425. 351676564346437/357896814346433.351676564346486/357896814346482. 351676564346510/357896814346516
. 351676564346544/357896814346540. 351676564346551/357896814346557. 351676564346569/357896814346565. 351676564346627/357896814346
623. 351676564346643/357896814346649. 351676564346700/357896814346706. 351676564346726/357896814346722. 351676564346775/357896814
346771. 351676564346791/357896814346797. 351676564346809/357896814346805. 351676564346817/357896814346813. 351676564346825/357896
814346821. 351676564346858/357896814346854. 351676564346866/357896814346862. 351676564346882/357896814346888. 351676564346916/357
896814346912. 351676564346940/357896814346946. 351676564346957/357896814346953. 351676564346965/357896814346961. 351676564346973/
357896814346979. 351676564346981/357896814346987. 351676564346999/357896814346995. 351676564347013/357896814347019. 3516765643472
60/357896814347266. 351676564347336/357896814347332. 351676564347344/357896814347340. 351676564347377/357896814347373. 3516765643
47401/357896814347407. 351676564347674/357896814347670. 351676564347781/357896814347787. 351676564347963/357896814347969. 3516765
64348052/357896814348058. 351676564348094/357896814348090. 351676564348102/357896814348108. 351676564348151/357896814348157. 3516
76564348730/357896814348736. 351676564349522/357896814349528. 351676564349639/357896814349635. 351676564349654/357896814349650. 3
51676564349670/357896814349676. 351676564349688/357896814349684. 351676564349696/357896814349692. 351676564349712/357896814349718
. 351676564349795/357896814349791. 351676564350439/357896814350435. 351676564354118/357896814354114. 351676564354142/357896814354
148. 351676564354191/357896814354197. 351676564354258/357896814354254. 351676564354274/357896814354270. 351676564354316/357896814
354312.351676564354340/357896814354346. 351676564354365/357896814354361. 351676564354381/357896814354387. 351676564354399/3578968
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032024001327912-9
Espacio para uso exclusivo de la Entidad Recaudadora
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