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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
032024001576805-6
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. 116575014962929
43 . Año – Mes – Día
2024 – 11 – 10
44 . Documento de transporte
No. 41N0688892
45 . Año – Mes – Día
2024 – 11 – 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
6900314534
52 . Año – Mes – Día
2024 – 10 – 29
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.
4.344.55
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.
166.00
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
24.541.15
79 . Valor fletes USD
1.337.96 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
112.438.518
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
112.438.518
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
1.25
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.339.21
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
25.880.36
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: 537274-DECL: 1855606-DO: 893126638241- 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: 3076649542. ID DELIVERY: 6078829917. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A065MLBGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A06 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL CLAR(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
032024001576805
133. Feha: 202411 12
134 . Levante No. 032024001478592 135 . Fecha
2024 – 11 – 12
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 92032408420387
Fecha presentación 2024-11-12 19:31:16
Valor pagado $0.00
Fecha de Impresión: 2024-11-12 19:31:22
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001576805-6
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
O, MODELO: SM-A065M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A065M/DS,LIGHT B LUE,LTC( QTY. 500,00 u )(50
0,00 PCE); IMEIS: 354106705095567/357809265095565. 354106705095575/357809265095573. 354106705095583/357809265095581. 354106705095
591/357809265095599. 354106705095609/357809265095607. 354106705095617/357809265095615. 354106705095625/357809265095623. 354106705
095633/357809265095631. 354106705095641/357809265095649. 354106705095658/357809265095656. 354106705095666/357809265095664. 354106
705095690/357809265095698. 354106705095708/357809265095706.354106705095724/357809265095722. 354106705095732/357809265095730. 3541
06705095740/357809265095748. 354106705095757/357809265095755. 354106705095765/357809265095763. 354106705095773/357809265095771. 3
54106705095781/357809265095789. 354106705095799/357809265095797. 354106705095815/357809265095813. 354106705095823/357809265095821
. 354106705095831/357809265095839. 354106705095849/357809265095847. 354106705095856/35780926 5095854. 354106705095864/35780926509
5862. 354106705095880/357809265095888. 354106705095898/357809265095896. 354106705095906/357809265095904.354106705095914/357809265
095912. 354106705095922/357809265095920. 354106705095930/357809265095938. 354106705095948/357809265095946. 354106705095955/357809
265095953. 354106705095971/357809265095979. 354106705095989/357809265095987. 354106705095997/357809265095995. 354106705096029/357
809265096027. 354106705096037/357809265096035. 354106705096045/357809265096043. 354106705096052/357809265096050. 354106705096060/
357809265096068. 354106705096086/357809265096084. 354106705096110/357809265096118. 354106705096128/357809265096126. 3541067050961
36/357809265096134. 354106705096144/357809265096142. 354106705096177/357809265096175. 354106705096185/357809265096183. 3541067050
96193/357809265096191. 354106705096201/357809265096209. 354106705096219/357809265096217. 354106705096227/357809265096225. 3541067
05096235/357809265096233. 354106705148382/357809265148380. 354106705149497/357809265149495. 354106705149570/357809265149578. 3541
06705157359/357809265157357. 354106705159975/357809265159973. 354106705161427/357809265161425. 354106705161708/357809265161706. 3
54106705162268/357809265162266. 354106705162375/357809265162373. 354106705162631/357809265162639. 354106705162656/357809265162654
. 354106705162714/357809265162712. 354106705162722/357809265162720. 354106705162748/357809265162746. 354106705162755/357809265162
753. 354106705162771/357809265162779. 354106705162797/357809265162795. 354106705162813/357809265162811. 354106705162839/357809265
162837. 354106705162847/357809265162845. 354106705162854/357809265162852. 354106705162862/357809265162860. 354106705162888/357809
265162886. 354106705162987/357809265162985. 354106705163001/357809265163009. 354106705163019/357809265163017. 354106705163068/357
809265163066. 354106705163258/357809265163256.354106705163340/357809265163348. 354106705163365/357809265163363. 354106705163407/3
57809265163405. 354106705163464/357809265163462. 354106705163514/357809265163512. 354106705163530/357809265163538. 35410670516357
1/357809265163579. 354106705163613/357809265163611. 354106705163621/357809265163629. 354106705163639/357809265163637. 35410670516
3647/357809265163645. 354106705163654/357809265163652. 354106705163670/357809265163678. 354106705163688/357809265163686. 35410670
5163696/357809265163694. 354106705163704/357809265163702. 354106705163712/357809265163710.354106705163720/357809265163728. 354106
705163753/357809265163751. 354106705163761/357809265163769. 354106705163787/357809265163785. 354106705163795/357809265163793. 354
106705163803/357809265163801. 354106705163829/357809265163827. 354106705163837/357809265163835. 354106705163845/357809265163843.
354106705163860/357809265163868. 354106705163878/357809265163876. 354106705163886/357809265163884. 354106705163894/35780926516389
2. 354106705163910/357809265163918. 354106705163928/357809265163926. 354106705163936/357809265163934. 354106705163944/35780926516
3942. 354106705163951/357809265163959. 354106705163977/357809265163975. 354106705163985/357809265163983. 354106705163993/35780926
5163991. 354106705164009/357809265164007. 354106705164017/357809265164015. 354106705164025/357809265164023. 354106705164033/35780
9265164031. 354106705164041/357809265164049. 354106705164058/357809265164056. 354106705164066/357809265164064. 354106705164082/35
7809265164080. 354106705164090/357809265164098. 354106705164108/357809265164106. 354106705164116/357809265164114. 354106705164124
/357809265164122. 354106705164132/357809265164130. 354106705164140/357809265164148. 354106705164157/357809265164155. 354106705164
173/357809265164171. 354106705164207/357809265164205. 354106705164215/357809265164213. 354106705164306/357809265164304. 354106704
948428/357809264948426. 354106704948444/357809264948442. 354106704948451/357809264948459. 354106704948477/357809264948475. 354106
704948568/357809264948566. 354106704948634/357809264948632. 354106704948667/357809264948665. 354106704948675/357809264948673. 354
106704948741/357809264948749. 354106704948758/357809264948756. 354106704948808/357809264948806. 354106704948972/357809264948970.
354106704949525/357809264949523.354106704949566/357809264949564. 354106704949657/357809264949655. 354106704949665/357809264949663
. 354106704949681/357809264949689. 354106704949756/357809264949754. 354106704949889/357809264949887. 354106704949897/357809264949
895. 354106704950010/357809264950018. 354106704950150/357809264950158. 354106704950226/357809264950224. 354106704950275/357809264
950273. 354106704950309/357809264950307. 354106704950382/357809264950380. 354106704950440/357809264950448. 354106704950507/357809
264950505. 354106704950564/357809264950562. 354106704950580/357809264950588.354106704950598/357809264950596. 354106704950614/3578
09264950612. 354106704950622/357809264950620. 354106704950648/357809264950646. 354106704950697/357809264950695. 354106704950739/3
57809264950737. 354106704950788/357809264950786. 354106704951091/357809264951099. 354106705011333/357809265011331. 35410670501142
4/357809265011422. 354106705011465/357809265011463. 354106705011630/357809265011638. 354106705011689/357809265011687. 35410670501
1762/357809265011760. 354106705011846/357809265011844. 354106705011861/357809265011869. 354106705011895/357809265011893. 35410670
5011929/357809265011927. 354106705011952/357809265011950. 354106705012018/357809265012016. 354106705012034/357809265012032. 35410
6705012182/357809265012180. 354106705012190/357809265012198. 354106705012208/357809265012206. 354106705012216/357809265012214. 35
4106705012257/357809265012255. 354106705012299/357809265012297. 354106705012331/357809265012339. 354106705012356/357809265012354.
354106705012372/357809265012370. 354106705012380/357809265012388. 354106705012471/357809265012479. 354106705012505/3578092650125
03. 354106705012521/357809265012529. 354106705012588/357809265012586. 354106705012604/357809265012602. 354106705012794/3578092650
12792. 354106705012927/357809265012925. 354106705012935/357809265012933. 354106705012950/357809265012958. 354106705012968/3578092
65012966. 354106705014865/357809265014863. 354106705014923/357809265014921. 354106705015045/357809265015043. 354106705015284/3578
09265015282. 354106705089941/357809265089949. 354106705089966/357809265089964. 354106705089974/357809265089972. 354106705089982/3
57809265089980. 354106705089990/357809265089998. 354106705090022/357809265090020. 354106705090030/357809265090038. 35410670509004
8/357809265090046.354106705090063/357809265090061. 354106705090071/357809265090079. 354106705090089/357809265090087. 354106705090
097/357809265090095. 354106705090105/357809265090103. 354106705090113/357809265090111. 354106705090121/357809265090129. 354106705
092994/357809265092992. 354106705093000/357809265093008. 354106705093018/357809265093016. 354106705093026/357809265093024. 354106
705093034/357809265093032. 354106705093042/357809265093040. 354106705093059/357809265093057. 354106705093158/357809265093156. 354
106705093307/357809265093305. 354106705093323/357809265093321.354106705093406/357809265093404. 354106705093430/357809265093438. 3
54106705093497/357809265093495. 354106705093547/357809265093545. 354106705093562/357809265093560. 354106705093588/357809265093586
. 354106705093596/357809265093594. 354106705093604/357809265093602. 354106705093612/357809265093610. 354106705093620/357809265093
628. 354106705093638/357809265093636. 354106705093646/357809265093644. 354106705093653/357809265093651. 354106705093679/357809265
093677. 354106705093687/357809265093685. 354106705093703/357809265093701. 354106705093711/357809265093719. 354106705093737/357809
265093735. 354106705093745/357809265093743. 354106705093752/357809265093750. 354106705093760/357809265093768. 354106705093778/357
809265093776. 354106705093794/357809265093792. 354106705093802/357809265093800. 354106705093810/357809265093818. 354106705093836/
357809265093834. 354106705093992/357809265093990. 354106705094016/357809265094014. 354106705094065/357809265094063. 3541067050940
99/357809265094097. 354106705094107/357809265094105. 354106705094180/357809265094188. 354106705094206/357809265094204. 3541067050
94214/357809265094212. 354106705094222/357809265094220. 354106705090139/357809265090137. 354106705090188/357809265090186. 3541067
05090196/357809265090194. 354106705090246/357809265090244. 354106705090287/357809265090285. 354106705090303/357809265090301. 3541
06705090311/357809265090319. 354106705090337/357809265090335. 354106705090352/357809265090350. 354106705090410/357809265090418. 3
54106705090477/357809265090475. 354106705090485/357809265090483. 354106705090519/357809265090517. 354106705090535/357809265090533
032024001576805-6
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001576805-6
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
. 354106705090543/357809265090541. 354106705090550/357809265090558. 354106705090576/357809265090574. 354106705090618/357809265090
616.354106705090642/357809265090640. 354106705090725/357809265090723. 354106705090741/357809265090749. 354106705090782/3578092650
90780. 354106705090808/357809265090806. 354106705090824/357809265090822. 354106705090832/357809265090830. 354106705090840/3578092
65090848. 354106705090865/357809265090863. 354106705090899/357809265090897. 354106705090907/357809265090905. 354106705090915/3578
09265090913. 354106705090949/357809265090947. 354106705090956/357809265090954. 354106705090964/357809265090962. 354106705090972/3
57809265090970. 354106705091038/357809265091036.354106705091046/357809265091044. 354106705091061/357809265091069. 354106705091079
/357809265091077. 354106705091137/357809265091135. 354106705091145/357809265091143. 354106705091152/357809265091150. 354106705091
160/357809265091168. 354106705091178/357809265091176. 354106705091186/357809265091184. 354106705091202/357809265091200. 354106705
091228/357809265091226. 354106705091269/357809265091267. 354106705091277/357809265091275. 354106705091285/357809265091283. 354106
705091293/357809265091291. 354106705091335/357809265091333. 354106705091350/357809265091358. 354106705091376/357809265091374. 354
106705091392/357809265091390. 354106705091426/357809265091424. 354106705091442/357809265091440. 354106705091491/357809265091499.
354106705091509/357809265091507. 354106705091517/357809265091515. 354106705091525/357809265091523. 354106705091541/35780926509154
9. 354106705091574/357809265091572. 354106705091616/357809265091614. 354106705091632/357809265091630. 354106705091640/35780926509
1648. 354106705091657/357809265091655. 354106705091673/357809265091671. 354106705091756/357809265091754. 354106705091764/35780926
5091762. 354106705091780/357809265091788. 354106705091806/357809265091804. 354106705091822/357809265091820. 354106705091830/35780
9265091838. 354106705091863/357809265091861. 354106705091871/357809265091879. 354106705091905/357809265091903. 354106705091921/35
7809265091929. 354106705091947/357809265091945. 354106705091954/357809265091952. 354106705091988/357809265091986. 354106705091996
/357809265091994. 354106705092002/357809265092000. 354106705092010/357809265092018. 354106705092028/357809265092026. 354106705092
036/357809265092034. 354106705092044/357809265092042. 354106705092077/357809265092075. 354106705092085/357809265092083.3541067050
92093/357809265092091. 354106705092119/357809265092117. 354106705092135/357809265092133. 354106705092143/357809265092141. 3541067
05092168/357809265092166. 354106705092176/357809265092174. 354106705092184/357809265092182. 354106705092200/357809265092208. 3541
06705092218/357809265092216. 354106705092234/357809265092232. 354106705092242/357809265092240. 354106705092259/357809265092257. 3
54106705092267/357809265092265. 354106705092275/357809265092273. 354106705092283/357809265092281. 354106705092291/357809265092299
. 354106705092325/357809265092323.354106705092333/357809265092331. 354106705092341/357809265092349. 354106705092358/3578092650923
56. 354106705092366/357809265092364. 354106705092374/357809265092372. 354106705092432/357809265092430. 354106705092556/3578092650
92554. 354106705092564/357809265092562. 354106705092572/357809265092570. 354106705092580/357809265092588. 354106705092598/3578092
65092596. 354106705092606/357809265092604. 354106705092614/357809265092612. 354106705092622/357809265092620. 354106705092630/3578
09265092638. 354106705092648/357809265092646. 354106705092655/357809265092653. 354106705092663/357809265092661. 354106705092705/3
57809265092703. 354106705092754/357809265092752. 354106705092762/357809265092760. 354106705092788/357809265092786. 35410670509280
4/357809265092802. 354106705092861/357809265092869. 354106705092879/357809265092877. 354106705092887/357809265092885. 35410670509
2903/357809265092901. 354106705092937/357809265092935. 354106705092952/357809265092950. 354106705092978/357809265092976. 35410670
5094230/357809265094238. 354106705094248/357809265094246. 354106705094271/357809265094279. 354106705094289/357809265094287. 35410
6705094297/357809265094295. 354106705094370/357809265094378. 354106705094594/357809265094592. 354106705094602/357809265094600. 35
4106705094610/357809265094618. 354106705094628/357809265094626. 354106705094636/357809265094634. 354106705094644/357809265094642.
354106705094651/357809265094659. 354106705094701/357809265094709. 354106705094719/357809265094717. 354106705094743/3578092650947
41. 354106705094768/357809265094766. 354106705094792/357809265094790. 354106705094800/357809265094808. 354106705094818/3578092650
94816. 354106705094826/357809265094824. 354106705094834/357809265094832. 354106705094842/357809265094840.354106705094859/35780926
5094857. 354106705094867/357809265094865. 354106705094875/357809265094873. 354106705094883/357809265094881. 354106705094891/35780
9265094899. 354106705094909/357809265094907. 354106705094917/357809265094915. 354106705094925/357809265094923. 354106705094933/35
7809265094931. 354106705094941/357809265094949. 354106705094958/357809265094956. 354106705094966/357809265094964. 354106705094974
/357809265094972. 354106705094982/357809265094980. 354106705094990/357809265094998. 354106705095005/357809265095003. 354106705095
021/357809265095029.354106705095039/357809265095037. 354106705095047/357809265095045. 354106705095054/357809265095052. 3541067050
95062/357809265095060. 354106705095070/357809265095078. 354106705095088/357809265095086. 354106705095096/357809265095094. 3541067
05095104/357809265095102. 354106705095112/357809265095110. 354106705095120/357809265095128. 354106705095138/357809265095136. 3541
06705095146/357809265095144. 354106705095153/357809265095151. 354106705095161/357809265095169. 354106705095179/357809265095177. 3
54106705095187/357809265095185. 354106705095195/357809265095193. 354106705095203/357809265095201. 354106705095211/357809265095219
. 354106705095229/357809265095227. 354106705095237/357809265095235. 354106705095245/357809265095243. 354106705095252/357809265095
250. 354106705095260/357809265095268. 354106705095278/357809265095276. 354106705095286/357809265095284. 354106705095294/357809265
095292. 354106705095302/357809265095300. 354106705095310/357809265095318. 354106705095328/357809265095326. 354106705095336/357809
265095334. 354106705095344/357809265095342. 354106705095351/357809265095359. 354106705095369/357809265095367. 354106705095377/357
809265095375. 354106705095385/357809265095383. 354106705095393/357809265095391. 354106705095401/357809265095409. 354106705095427/
357809265095425. 354106705095443/357809265095441. 354106705095450/357809265095458. 354106705095468/357809265095466. 3541067050954
76/357809265095474. 354106705095484/357809265095482. 354106705095492/357809265095490. 354106705095500/357809265095508. 3541067050
95518/357809265095516. 354106705095526/357809265095524. 354106705095534/357809265095532. 354106705095559/357809265095557XXXXXXXXX
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032024001576805-6
Espacio para uso exclusivo de la Entidad Recaudadora
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