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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
032024001444933-4
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. 116575014882892
43 . Año – Mes – Día
2024 – 10 – 16
44 . Documento de transporte
No. HKJ011456
45 . Año – Mes – Día
2024 – 10 – 12
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
6900308626
52 . Año – Mes – Día
2024 – 09 – 30
53 . Cod. país
procedencia
351
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.
4.217.40
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.
140.00
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
17.697.85
79 . Valor fletes USD
935.20 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
936.10
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: 534338-DECL: 1848175-DO: 893124629241- 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: 3074298659. ID CONTEN
EDOR: 6078478266. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZSDLTC, PRODUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS
PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, MODELO: SM-A055M/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
032024001444933
133. Feha: 202410 17
134 . Levante No. 032024001357876 135 . Fecha
2024 – 10 – 17
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 92032407737514
Fecha presentación 2024-10-17 13:01:15
Valor pagado $0.00
Fecha de Impresión: 2024-10-17 13:01:21
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001444933-4
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
R Y AL DETAL/ /MOBILE,SM-A055M/DS,SILVER,LTC( QTY. 400,00 u )(400,00 PCE); IMEIS: 351864759308939/354706949308930. 35186475930894
7/354706949308948. 351864759308962/354706949308963. 351864759308996/354706949308997. 351864759309002/354706949309003. 35186475930
9010/354706949309011. 351864759309069/354706949309060. 351864759309705/354706949309706. 351864759309713/354706949309714. 35186475
9309754/354706949309755. 351864759309788/354706949309789. 351864759309796/354706949309797. 351864759309812/354706949309813. 35186
4759309820/354706949309821. 351864759309846/354706949309847. 351864759309853/354706949309854. 351864759309861/354706949309862. 35
1864759309879/354706949309870. 351864759309887/354706949309888. 351864759309895/354706949309896. 351864759309945/354706949309946.
351864759310349/354706949310340. 351864759310521/354706949310522. 351864759310679/354706949310670. 351864759310778/3547069493107
79. 351864759310851/354706949310852. 351864759310877/354706949310878. 351864759311073/354706 949311074. 351864759311149/354706949
311140. 351864759311248/354706949311249. 351864759311404/354706949311405. 351864759311420/354706949311421. 351864759311453/354706
949311454. 351864759312030/354706949312031. 351864759312048/354706949312049. 351864759312063/354706949312064. 351864759312279/354
706949312270. 351864759312311/354706949312312. 351864759312527/354706949312528. 351864759312709/354706949312700. 351864759313079/
354706949313070. 351864759313160/354706949313161. 351864759314135/354706949314136. 351864759314218/354706949314219. 3518647593142
34/354706949314235. 351864759314291/354706949314292. 351864759314341/354706949314342. 351864759314432/354706949314433. 3518647593
14747/354706949314748. 351864759314812/354706949314813. 351864759314838/354706949314839.351864759314846/354706949314847. 35186475
9314861/354706949314862. 351864759314952/354706949314953. 351864759315017/354706949315018. 351864759315108/354706949315109. 35186
4759315124/354706949315125. 351864759315140/354706949315141. 351864759315157/354706949315158. 351864759315165/354706949315166. 35
1864759315199/354706949315190. 351864759315264/354706949315265. 351864759315363/354706949315364. 351864759315371/354706949315372.
351864759315439/354706949315430. 351864759315470/354706949315471. 351864759315611/354706949315612. 351864759315629/3547069493156
20.351864759315637/354706949315638. 351864759315645/354706949315646. 351864759315686/354706949315687. 351864759315694/35470694931
5695. 351864759315702/354706949315703. 351864759315736/354706949315737. 351864759315751/354706949315752. 351864759315769/35470694
9315760. 351864759315793/354706949315794. 351864759315801/354706949315802. 351864759315819/354706949315810. 351864759315827/35470
6949315828. 351864759315835/354706949315836. 351864759315843/354706949315844. 351864759315850/354706949315851. 351864759315868/35
4706949315869. 351864759315876/354706949315877. 351864759315884/354706949315885. 351864759315892/354706949315893. 351864759315900
/354706949315901. 351864759315983/354706949315984. 351864759316007/354706949316008. 351864759316015/354706949316016. 351864759316
031/354706949316032. 351864759316049/354706949316040. 351864759316056/354706949316057. 351864759316064/354706949316065. 351864759
316072/354706949316073. 351864759316080/354706949316081. 351864759316098/354706949316099. 351864759316106/354706949316107. 351864
759316114/354706949316115. 351864759316122/354706949316123. 351864759316130/354706949316131. 351864759316148/354706949316149. 351
864759316155/354706949316156. 351864759316189/354706949316180. 351864759316197/354706949316198. 351864759316205/354706949316206.
351864759316213/354706949316214. 351864759316221/354706949316222. 351864759316239/354706949316230. 351864759316247/35470694931624
8. 351864759316254/354706949316255. 351864759316262/354706949316263. 351864759316270/354706949316271. 351864759316288/35470694931
6289. 351864759316296/354706949316297. 351864759316304/354706949316305. 351864759316312/354706949316313. 351864759316320/35470694
9316321. 351864759316338/354706949316339. 351864759316346/354706949316347.351864759316353/354706949316354. 351864759316361/354706
949316362. 351864759316387/354706949316388. 351864759316395/354706949316396. 351864759316403/354706949316404. 351864759316411/354
706949316412. 351864759316429/354706949316420. 351864759316452/354706949316453. 351864759316494/354706949316495. 351864759316502/
354706949316503. 351864759316510/354706949316511. 351864759316528/354706949316529. 351864759316536/354706949316537. 3518647593165
44/354706949316545. 351864759316551/354706949316552. 351864759316569/354706949316560. 351864759316585/354706949316586.35186475931
6601/354706949316602. 351864759316619/354706949316610. 351864759316635/354706949316636. 351864759316650/354706949316651. 35186475
9316676/354706949316677. 351864759316684/354706949316685. 351864759316692/354706949316693. 351864759316700/354706949316701. 35186
4759316726/354706949316727. 351864759316734/354706949316735. 351864759316742/354706949316743. 351864759316759/354706949316750. 35
1864759316775/354706949316776. 351864759316783/354706949316784. 351864759316817/354706949316818. 351864759316825/354706949316826.
351864759316833/354706949316834. 351864759316866/354706949316867. 351864759316882/354706949316883. 351864759316890/3547069493168
91. 351864759316908/354706949316909. 351864759316916/354706949316917. 351864759316932/354706949316933. 351864759316973/3547069493
16974. 351864759316999/354706949316990. 351864759317013/354706949317014. 351864759317021/354706949317022. 351864759317039/3547069
49317030. 351864759317047/354706949317048. 351864759317054/354706949317055. 351864759317062/354706949317063. 351864759317070/3547
06949317071. 351864759317088/354706949317089. 351864759317096/354706949317097. 351864759317120/354706949317121. 351864759317138/3
54706949317139. 351864759317153/354706949317154. 351864759317161/354706949317162. 351864759317179/354706949317170. 35186475931720
3/354706949317204. 351864759317211/354706949317212. 351864759317229/354706949317220. 351864759317237/354706949317238. 35186475931
7245/354706949317246. 351864759317252/354706949317253. 351864759317278/354706949317279. 351864759317286/354706949317287. 35186475
9317310/354706949317311. 351864759317336/354706949317337. 351864759317344/354706949317345. 351864759317351/354706949317352. 35186
4759317369/354706949317360. 351864759317385/354706949317386.351864759317393/354706949317394. 351864759317401/354706949317402. 351
864759317419/354706949317410. 351864759317427/354706949317428. 351864759317435/354706949317436. 351864759317450/354706949317451.
351864759317468/354706949317469. 351864759317476/354706949317477. 351864759317484/354706949317485. 351864759317500/35470694931750
1. 351864759317518/354706949317519. 351864759317534/354706949317535. 351864759317542/354706949317543. 351864759317559/35470694931
7550. 351864759317567/354706949317568. 351864759317575/354706949317576. 351864759317583/354706949317584.351864759317591/354706949
317592. 351864759317609/354706949317600. 351864759317617/354706949317618. 351864759317625/354706949317626. 351864759317633/354706
949317634. 351864759317641/354706949317642. 351864759317658/354706949317659. 351864759317666/354706949317667. 351864759317682/354
706949317683. 351864759317690/354706949317691. 351864759317716/354706949317717. 351864759317724/354706949317725. 351864759317757/
354706949317758. 351864759317773/354706949317774. 351864759317831/354706949317832. 351864759317849/354706949317840. 3518647593178
56/354706949317857. 351864759317872/354706949317873. 351864759317880/354706949317881. 351864759317898/354706949317899. 3518647593
17914/354706949317915. 351864759317922/354706949317923. 351864759317930/354706949317931. 351864759317948/354706949317949. 3518647
59317989/354706949317980. 351864759318011/354706949318012. 351864759318037/354706949318038. 351864759318060/354706949318061. 3518
64759318094/354706949318095. 351864759318102/354706949318103. 351864759318110/354706949318111. 351864759318128/354706949318129. 3
51864759318144/354706949318145. 351864759318151/354706949318152. 351864759318177/354706949318178. 351864759318185/354706949318186
. 351864759318193/354706949318194. 351864759318201/354706949318202. 351864759318219/354706949318210. 351864759318326/354706949318
327. 351864759318342/354706949318343. 351864759318359/354706949318350. 351864759318367/354706949318368. 351864759318375/354706949
318376. 351864759318383/354706949318384. 351864759318391/354706949318392. 351864759318409/354706949318400. 351864759318417/354706
949318418. 351864759318433/354706949318434. 351864759318466/354706949318467. 351864759318482/354706949318483. 351864759318490/354
706949318491. 351864759318508/354706949318509.351864759318516/354706949318517. 351864759318532/354706949318533. 351864759318540/3
54706949318541. 351864759318557/354706949318558. 351864759318565/354706949318566. 351864759318573/354706949318574. 35186475931859
9/354706949318590. 351864759318607/354706949318608. 351864759318615/354706949318616. 351864759318623/354706949318624. 35186475931
8631/354706949318632. 351864759318649/354706949318640. 351864759318656/354706949318657. 351864759318672/354706949318673. 35186475
9318680/354706949318681. 351864759318698/354706949318699. 351864759318722/354706949318723.351864759318730/354706949318731. 351864
759318748/354706949318749. 351864759318763/354706949318764. 351864759318771/354706949318772. 351864759318789/354706949318780. 351
864759318805/354706949318806. 351864759318813/354706949318814. 351864759318821/354706949318822. 351864759318839/354706949318830.
351864759318862/354706949318863. 351864759318870/354706949318871. 351864759318896/354706949318897. 351864759318904/35470694931890
032024001444933-4
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001444933-4
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
5. 351864759318912/354706949318913. 351864759318938/354706949318939. 351864759318953/354706949318954. 351864759318961/35470694931
8962. 351864759318987/354706949318988. 351864759318995/354706949318996. 351864759319001/354706949319002. 351864759319035/35470694
9319036. 351864759319050/354706949319051. 351864759319076/354706949319077. 351864759319084/354706949319085. 351864759319092/35470
6949319093. 351864759319100/354706949319101. 351864759319126/354706949319127. 351864759319175/354706949319176. 351864759319191/35
4706949319192. 351864759319209/354706949319200. 351864759319217/354706949319218. 351864759319225/354706949319226. 351864759319233
/354706949319234. 351864759319241/354706949319242. 351864759319258/354706949319259. 351864759319266/354706949319267. 351864759319
274/354706949319275. 351864759319290/354706949319291. 351864759319308/354706949319309. 351864759319316/354706949319317. 351864759
319324/354706949319325. 351864759319332/354706949319333. 351864759319340/354706949319341. 351864759319365/354706949319366. 351864
759319373/354706949319374. 351864759319381/354706949319382. 351864759319399/354706949319390. 351864759319407/354706949319408. 351
864759319423/354706949319424. 351864759319431/354706949319432. 351864759319449/354706949319440. 351864759319456/354706949319457.
351864759319464/354706949319465.351864759319472/354706949319473. 351864759319480/354706949319481. 351864759319498/354706949319499
. 351864759319506/354706949319507. 351864759319514/354706949319515. 351864759319522/354706949319523. 351864759319530/354706949319
531. 351864759319548/354706949319549. 351864759319555/354706949319556. 351864759319563/354706949319564. 351864759319571/354706949
319572. 351864759319589/354706949319580. 351864759319605/354706949319606. 351864759319613/354706949319614. 351864759319621/354706
949319622. 351864759319639/354706949319630. 351864759319647/354706949319648.351864759319654/354706949319655. 351864759319662/3547
06949319663. 351864759319688/354706949319689. 351864759319704/354706949319705. 351864759319712/354706949319713. 351864759319720/3
54706949319721. 351864759319746/354706949319747. 351864759319753/354706949319754. 351864759319761/354706949319762. 35186475931978
7/354706949319788. 351864759319803/354706949319804. 351864759319811/354706949319812. 351864759319829/354706949319820. 35186475931
9837/354706949319838. 351864759319845/354706949319846. 351864759319910/354706949319911. 351864759319944/354706949319945. 35186475
9319951/354706949319952. 351864759319969/354706949319960. 351864759319985/354706949319986. 351864759320017/354706949320018. 35186
4759320033/354706949320034. 351864759320066/354706949320067. 351864759320322/354706949320323. 351864759320330/354706949320331. 35
1864759320454/354706949320455. 351864759320462/354706949320463. 351864759320595/354706949320596. 351864759320637/354706949320638.
351864759320736/354706949320737. 351864759320769/354706949320760. 351864759320777/354706949320778. 351864759320785/3547069493207
86. 351864759320801/354706949320802. 351864759320850/354706949320851. 351864759320868/354706949320869. 351864759320876/3547069493
20877. 351864759320926/354706949320927. 351864759320959/354706949320950. 351864759320967/354706949320968. 351864759320975/3547069
49320976. 351864759320983/354706949320984. 351864759320991/354706949320992. 351864759321023/354706949321024. 351864759321031/3547
06949321032. 351864759321049/354706949321040. 351864759321064/354706949321065. 351864759321072/354706949321073. 351864759321114/3
54706949321115. 351864759321122/354706949321123. 351864759321163/354706949321164. 351864759321270/354706949321271XXXXXXXXXXXXXXXX
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032024001444933-4
Espacio para uso exclusivo de la Entidad Recaudadora
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