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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
032024001438413-1
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
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. 116575014877939
43 . Año – Mes – Día
2024 – 10 – 15
44 . Documento de transporte
No. HKG0400798
45 . Año – Mes – Día
2024 – 10 – 10
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
6900307858
52 . Año – Mes – Día
2024 – 09 – 30
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
244
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.217.40
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.
139.00
72 . Peso neto kgs. dcms.
108.40
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
17.534.95
79 . Valor fletes USD
1.098.10 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
78.586.821
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
78.586.821
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
0.90
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.099.00
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
18.633.95
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: 534198-DECL: 1847791-DO: 893124185241- 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: 3074298744. ID CONTENEDOR: 6078457125. MERCANCIA MARCA: SAMSUNG REFERENCIA:SM-A055MZSDLTC, PR
ODUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, M(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
032024001438413
133. Feha: 202410 16
134 . Levante No. 032024001351522 135 . Fecha
2024 – 10 – 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 92032407702036
Fecha presentación 2024-10-16 12:45:47
Valor pagado $0.00
Fecha de Impresión: 2024-10-16 12:45:52
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001438413-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,SILVER,LTC( QTY. 400,00 u )(400,00 PCE)
; IMEIS: 351864759322823/354706949322824. 351864759322856/354706949322857. 351864759322864/354706949322865. 351864759322872/35470
6949322873. 351864759322880/354706949322881. 351864759322898/354706949322899. 351864759322906/354706949322907. 351864759322922/35
4706949322923. 351864759322930/354706949322931.351864759322955/354706949322956. 351864759322963/354706949322964. 351864759322971/
354706949322972. 351864759322989/354706949322980. 351864759323011/354706949323012. 351864759323029/354706949323020. 3518647593230
52/354706949323053. 351864759323060/354706949323061. 351864759323078/354706949323079. 351864759323102/354706949323103. 3518647593
23110/354706949323111. 351864759323128/354706949323129. 351864759323136/354706949323137. 351864759323144/354706949323145. 3518647
59323169/354706949323160. 351864759323185/354706949323186. 351864759323193/354706949323194. 351864759323201/354706949323202. 3518
64759323219/354706949323210. 351864759323235/354706949323236. 351864759323250/354706949323251. 351864759323268/354706949323269. 3
51864759323276/354706949323277. 351864759323284/354706949323285. 351864759323292/354706949323293. 351864759323326/354706949323327
. 351864759323334/354706949323335. 351864759323342/354706949323343. 351864759323359/354706949323350. 351864759323367/354706949323
368. 351864759323375/354706949323376. 351864759308715/354706949308716. 351864759308723/354706949308724. 351864759308731/354706949
308732. 351864759308749/354706949308740. 351864759308756/354706949308757. 351864759308772/354706949308773. 351864759308780/354706
949308781. 351864759308798/354706949308799. 351864759308814/354706949308815. 351864759308822/354706949308823. 351864759308830/354
706949308831. 351864759308848/354706949308849. 351864759308855/354706949308856. 351864759308897/354706949308898. 351864759308905/
354706949308906. 351864759308913/354706949308914. 351864759308921/354706949308922. 351864759308954/354706949308955. 3518647593089
70/354706949308971. 351864759308988/354706949308989. 351864759309333/354706949309334. 351864759309408/354706949309409. 3518647593
09440/354706949309441. 351864759309531/354706949309532. 351864759309556/354706949309557. 351864759309606/354706949309607. 3518647
59309614/354706949309615. 351864759309648/354706949309649. 351864759309739/354706949309730. 351864759309762/354706949309763. 3518
64759309804/354706949309805. 351864759309911/354706949309912. 351864759309960/354706949309961. 351864759309978/354706949309979. 3
51864759310000/354706949310001. 351864759310018/354706949310019. 351864759310034/354706949310035. 351864759310042/354706949310043
. 351864759310067/354706949310068.351864759310075/354706949310076. 351864759310083/354706949310084. 351864759310091/3547069493100
92. 351864759310117/354706949310118. 351864759310125/354706949310126. 351864759310133/354706949310134. 351864759310141/3547069493
10142. 351864759310158/354706949310159. 351864759310166/354706949310167. 351864759310174/354706949310175. 351864759310182/3547069
49310183. 351864759310190/354706949310191. 351864759310216/354706949310217. 351864759310224/354706949310225. 351864759310232/3547
06949310233. 351864759310240/354706949310241. 351864759310257/354706949310258.351864759310265/354706949310266. 351864759310273/35
4706949310274. 351864759310299/354706949310290. 351864759310315/354706949310316. 351864759310323/354706949310324. 351864759310356
/354706949310357. 351864759310364/354706949310365. 351864759310380/354706949310381. 351864759310398/354706949310399. 351864759310
406/354706949310407. 351864759310422/354706949310423. 351864759310430/354706949310431. 351864759310448/354706949310449. 351864759
310455/354706949310456. 351864759310463/354706949310464. 351864759310489/354706949310480. 351864759310497/354706949310498. 351864
759310513/354706949310514. 351864759310620/354706949310621. 351864759310687/354706949310688. 351864759310695/354706949310696. 351
864759310703/354706949310704. 351864759310786/354706949310787. 351864759310901/354706949310902. 351864759310943/354706949310944.
351864759310950/354706949310951. 351864759310976/354706949310977. 351864759310992/354706949310993. 351864759311008/35470694931100
9. 351864759311081/354706949311082. 351864759311594/354706949311595. 351864759311701/354706949311702. 351864759311776/35470694931
1777. 351864759311818/354706949311819. 351864759311834/354706949311835. 351864759311966/354706949311967. 351864759312071/35470694
9312072. 351864759312105/354706949312106. 351864759312113/354706949312114. 351864759312188/354706949312189. 351864759312204/35470
6949312205. 351864759312220/354706949312221. 351864759312287/354706949312288. 351864759312329/354706949312320. 351864759312360/35
4706949312361. 351864759312378/354706949312379. 351864759312386/354706949312387. 351864759312436/354706949312437. 351864759312485
/354706949312486. 351864759312550/354706949312551. 351864759312592/354706949312593. 351864759312675/354706949312676. 351864759312
683/354706949312684.351864759312758/354706949312759. 351864759312774/354706949312775. 351864759313244/354706949313245. 3518647593
13343/354706949313344. 351864759313368/354706949313369. 351864759313442/354706949313443. 351864759314069/354706949314060. 3518647
59314200/354706949314201. 351864759314390/354706949314391. 351864759314531/354706949314532. 351864759314929/354706949314920. 3518
64759315025/354706949315026. 351864759315991/354706949315992. 351864759316445/354706949316446. 351864759316627/354706949316628. 3
51864759316718/354706949316719. 351864759316809/354706949316800.351864759317112/354706949317113. 351864759317260/354706949317261.
351864759317294/354706949317295. 351864759317328/354706949317329. 351864759317377/354706949317378. 351864759317674/3547069493176
75. 351864759317732/354706949317733. 351864759317740/354706949317741. 351864759317799/354706949317790. 351864759317807/3547069493
17808. 351864759317823/354706949317824. 351864759317864/354706949317865. 351864759317906/354706949317907. 351864759317955/3547069
49317956. 351864759317963/354706949317964. 351864759317971/354706949317972. 351864759317997/354706949317998. 351864759318003/3547
06949318004. 351864759318029/354706949318020. 351864759318045/354706949318046. 351864759318078/354706949318079. 351864759318086/3
54706949318087. 351864759318169/354706949318160. 351864759318227/354706949318228. 351864759318235/354706949318236. 35186475931824
3/354706949318244. 351864759318250/354706949318251. 351864759318276/354706949318277. 351864759318284/354706949318285. 35186475931
8292/354706949318293. 351864759318300/354706949318301. 351864759318318/354706949318319. 351864759318425/354706949318426. 35186475
9318458/354706949318459. 351864759318524/354706949318525. 351864759318581/354706949318582. 351864759318664/354706949318665. 35186
4759318706/354706949318707. 351864759318847/354706949318848. 351864759318888/354706949318889. 351864759318920/354706949318921. 35
1864759318946/354706949318947. 351864759318979/354706949318970. 351864759319019/354706949319010. 351864759319027/354706949319028.
351864759319043/354706949319044. 351864759319118/354706949319119. 351864759319134/354706949319135. 351864759319159/3547069493191
50. 351864759319167/354706949319168. 351864759319183/354706949319184. 351864759319282/354706949319283. 351864759319357/3547069493
19358.351864759319415/354706949319416. 351864759319597/354706949319598. 351864759319738/354706949319739. 351864759319779/35470694
9319770. 351864759319852/354706949319853. 351864759319878/354706949319879. 351864759319886/354706949319887. 351864759319894/35470
6949319895. 351864759319902/354706949319903. 351864759319936/354706949319937. 351864759319977/354706949319978. 351864759319993/35
4706949319994. 351864759320009/354706949320000. 351864759320025/354706949320026. 351864759320041/354706949320042. 351864759320058
/354706949320059. 351864759320074/354706949320075.351864759320082/354706949320083. 351864759320090/354706949320091. 3518647593201
08/354706949320109. 351864759320124/354706949320125. 351864759320132/354706949320133. 351864759320140/354706949320141. 3518647593
20157/354706949320158. 351864759320165/354706949320166. 351864759320199/354706949320190. 351864759320207/354706949320208. 3518647
59320215/354706949320216. 351864759320223/354706949320224. 351864759320249/354706949320240. 351864759320256/354706949320257. 3518
64759320264/354706949320265. 351864759320272/354706949320273. 351864759320280/354706949320281. 351864759320298/354706949320299. 3
51864759320306/354706949320307. 351864759320314/354706949320315. 351864759320421/354706949320422. 351864759320470/354706949320471
. 351864759320488/354706949320489. 351864759320496/354706949320497. 351864759320504/354706949320505. 351864759320512/354706949320
513. 351864759320520/354706949320521. 351864759320538/354706949320539. 351864759320546/354706949320547. 351864759320553/354706949
320554. 351864759320561/354706949320562. 351864759320579/354706949320570. 351864759320587/354706949320588. 351864759320603/354706
949320604. 351864759320645/354706949320646. 351864759320660/354706949320661. 351864759320678/354706949320679. 351864759320686/354
706949320687. 351864759320694/354706949320695. 351864759320702/354706949320703. 351864759320710/354706949320711. 351864759320728/
354706949320729. 351864759320751/354706949320752. 351864759320793/354706949320794. 351864759320819/354706949320810. 3518647593208
27/354706949320828. 351864759320835/354706949320836. 351864759320843/354706949320844. 351864759320884/354706949320885. 3518647593
20892/354706949320893. 351864759320900/354706949320901. 351864759320918/354706949320919. 351864759320934/354706949320935.35186475
032024001438413-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001438413-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
9320942/354706949320943. 351864759321015/354706949321016. 351864759321056/354706949321057. 351864759321080/354706949321081. 35186
4759321098/354706949321099. 351864759321130/354706949321131. 351864759321155/354706949321156. 351864759321171/354706949321172. 35
1864759321189/354706949321180. 351864759321197/354706949321198. 351864759321205/354706949321206. 351864759321213/354706949321214.
351864759321221/354706949321222. 351864759321239/354706949321230. 351864759321247/354706949321248. 351864759321288/3547069493212
89. 351864759321296/354706949321297.351864759321304/354706949321305. 351864759321312/354706949321313. 351864759321320/35470694932
1321. 351864759321338/354706949321339. 351864759321346/354706949321347. 351864759321353/354706949321354. 351864759321361/35470694
9321362. 351864759321379/354706949321370. 351864759321395/354706949321396. 351864759321403/354706949321404. 351864759321411/35470
6949321412. 351864759321429/354706949321420. 351864759321437/354706949321438. 351864759321460/354706949321461. 351864759321478/35
4706949321479. 351864759321494/354706949321495. 351864759321502/354706949321503. 351864759321510/354706949321511. 351864759321528
/354706949321529. 351864759321536/354706949321537. 351864759321544/354706949321545. 351864759321551/354706949321552. 351864759321
569/354706949321560. 351864759321577/354706949321578. 351864759321585/354706949321586. 351864759321627/354706949321628. 351864759
321635/354706949321636. 351864759321668/354706949321669. 351864759321676/354706949321677. 351864759321684/354706949321685. 351864
759321692/354706949321693. 351864759321718/354706949321719. 351864759321734/354706949321735. 351864759321742/354706949321743. 351
864759321759/354706949321750. 351864759321767/354706949321768. 351864759321775/354706949321776. 351864759321783/354706949321784.
351864759321809/354706949321800. 351864759321817/354706949321818. 351864759321825/354706949321826. 351864759321833/35470694932183
4. 351864759321858/354706949321859. 351864759321866/354706949321867. 351864759321874/354706949321875. 351864759321882/35470694932
1883. 351864759321908/354706949321909. 351864759321924/354706949321925. 351864759321932/354706949321933. 351864759321940/35470694
9321941. 351864759321957/354706949321958. 351864759321965/354706949321966. 351864759321973/354706949321974.351864759321981/354706
949321982. 351864759321999/354706949321990. 351864759322005/354706949322006. 351864759322013/354706949322014. 351864759322021/354
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354706949322071. 351864759322096/354706949322097. 351864759322104/354706949322105. 351864759322112/354706949322113. 3518647593221
20/354706949322121. 351864759322138/354706949322139. 351864759322146/354706949322147. 351864759322153/354706949322154. 3518647593
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9322245/354706949322246. 351864759322252/354706949322253. 351864759322260/354706949322261. 351864759322286/354706949322287. 35186
4759322302/354706949322303. 351864759322336/354706949322337. 351864759322369/354706949322360. 351864759322401/354706949322402. 35
1864759322450/354706949322451. 351864759322492/354706949322493. 351864759322666/354706949322667. 351864759322674/354706949322675.
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58. 351864759322765/354706949322766. 351864759322773/354706949322774. 351864759322781/354706949322782. 351864759322799/3547069493
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032024001438413-1
Espacio para uso exclusivo de la Entidad Recaudadora
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