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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
0320240016634593
5 . Número de Identificación Tributaria (NIT)
800091549
6 . DV.
2
11 . Apellidos y nombres o Razón Social
IMPRESISTEM S A S
13 . Dirección
AUT MEDELLIN CL 80 KM 2
15 . Teléfono
8766500
12 . Cód. Admón.
03
16 . Cód. Dpto
25
17 . Cód. Ciudad Municipio
214
24 . Número de Identificación Tributaria (NIT)
830122083
25 . DV.
6
26 . Razón social del declarante autorizado
AGENCIA DE ADUANAS LATINOAMERICANA DE ADUANAS SAS NIVEL 2
27 . Tipo usuario
26
28 . Cód. usuario
459
29 . Número documento de identificación
1023862658
30 . Apellidos y nombres
GONZALEZ ACERO KELLY JOHANNA
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
26924
42 . Manifiesto de carga
No. 116575015000611
43 . Año Mes
Día
2024 11
21
44 . Documento de transporte
No. 41N0692704
45 . Año Mes
Día
2024 11
14
46 . Nombre exportador o proveedor en el exterior
IMC INTERNATIONAL INC
47 . Ciudad
MIAMI
48 . Cod.País Exportador
249
49 . Dirección exportador o proveedor en el exterior
7707 NW 46 STREET MIAMI, FL 33166
50 . Email
3059947965
51 . No. de factura
21658
52 . Año Mes
Día
2024 11
14
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
169
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.387.09
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
03
69 . Tipo de
importación
01
70 . Cod. país
compra
249
71 . Peso bruto kgs. dcms.
374.50
72 . Peso neto kgs. dcms.
337.05
73 . Código
embalaje
PK
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
1.150.00
78 .Valor FOB
USD
79 . Valor fletes USD
Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93 94
0
95
0
96
0.00
I.V.A.
97
0.00
98 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
81 . Valor Otros Gastos USD
0
82 . Sumatoria
de fletes,
seguros
y otros gastos
USD
83 . Ajuste valor USD
0.00
84 . Valor
aduana USD
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)
DO 202431713 CODIGO / RESOLUCION OEA IMPORTADOR: OE0169; DECLARACION(11)
NOS ACOGEMOS AL ART 424 DEL ESTATUTO TRIBUTARIO MODIFIC
ADO POR LEY 1819 DE 29 DE DICIEMBRE 2016, NUEVA REFORMA TRIBUTARIA, ART 175 PARA COMPUTADORES PORTATILES, DE ESCRITORIO TABLETAS
Y CELULARES.// HOMOLOGACION DE EQUIPO MARCA REDMI MODELO: 2409BRN2CL, RADICACION: 2024523502, FECHA: 20240729//
DOCUMENTO DE VE
RIFICACION DE IMEI: DV219064,
FECHA: 20241120//.
FACTURA: 21658 FECHA: 20241114
NOS ACOGEMOS AL DECRETO 1881 DEL 2021, NOS A
COGEMOS AL DECRETO 0925 DE MAYO 9 DEL 2013, MINISTERIO DE COMERCIO EXTERIOR, IMPORTACIÓN EXENTA DE REGISTRO DE IMPORTACIÓN.. CANT
(1150) UND TELEFONO CELULAR, 1064244 REDMI 14C STARRY BLUE 4GB RAM 128GB ROM // ESPECIFICACIONES: PROCESAD(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
032024001663459
133. Feha: 2024 11 27
134 . Levante No. 032024001586758 135 . Fecha
2024 11
27
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 92032408873661
Fecha presentación 20241127
15:39:04
Valor pagado $0.00
Fecha de Impresión: 20241127
15:42:34
Kelly Johanna Gonzalez Acero
C.C 1.023.862.658
REPÚBLICA DE COLOMBIA
Declaración
de
Importación
Aceptación :
0320240016634593
Subpartida :
8517130000
Página 1 de 7
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
OR: MEDIATEK HELIO G81 ULTRA, PANTALLA: 6.88 PULGADAS (17.47 CM), MEMORIA: 4GB, ALMACENAMIENTO: 128GB, SISTEMA OPERATIVO: HYPEROS
// EAN: 6941812762820 // REDMI 14C AZUL ASTRAL (4GB RAM128GB
ROM), ALIMENTACION: 5V3A/
3.611V3A
(33 WMAX), CONTIENE: TELEFONO
CELULAR, ADAPTADOR DE CORRIENTE, CABLE USB TIPOC,
LLAVE PARA SIM CARD, CARCASA PROTECTORA, GUIA DE INICIO RAPIDO, TARJETA DE GAR
ANTIA. //PRODUCTO TERMOSELLADO. //COD: 1064244. PRODUCTO: TELEFONO CELULAR, MARCA: REDMI/MI, MODELO: 2409BRN2CL, REFERENCIA: 5914
1/MZB0HX6US, USO O DESTINO: COMUNICACIÓN, PARA ALMACENAMIENTO Y PROCESAMIENTO DE DATOS, SERIAL // IMEI NO. (CODIGO DE QUINCE 15DIGITOS):
59141/64XB00097//867070070211664//867070070211672, 59141/64XB00323//867070070209445//867070070209452, 59141/64XB00330/
/867070070209585//867070070209593, 59141/64XB00391//867070070195602//867070070195610, 59141/64XB00749//867070070200485//867070070
200493, 59141/64XB00956//867070070214122//867070070214130, 59141/64XB00985//867070070214700//867070070214718, 59141/64XB01014//86
6572077570407//866572077570415, 59141/64XB01091//866572077562248//866572077562255, 59141/64XB01114//866572077562701//866572077562
719, 59141/64XB01205//866572077562883//866572077562891, 59141/64XB01251//866572077571868//866572077571876, 59141/64XB01469//86657
2077561604//866572077561612, 59141/64XB01504//866572077564764//866572077564772, 59141/64XB01554//866572077572981//866572077572999
, 59141/64XB01555//866572077573005//866572077573013, 59141/64XB01581//866572077565480//866572077565498, 59141/64XB01583//86657207
7565522//866572077565530, 59141/64XB01585//866572077565563//866572077565571, 59141/64XB01587//866572077565605//866572077565613, 5
9141/64XB01589//866572077565647//866572077565654, 59141/64XB01594//866572077565746//866572077565753, 59141/64XB01595//86657207756
5761//866572077565779, 59141/64XB01597//866572077565803//866572077565811, 59141/64XB01598//866572077565829//866572077565837, 5914
1/64XB01605//866572077565969//866572077565977, 59141/64XB01607//866572077566009//866572077566017, 59141/64XB01642//86657207755742
0//866572077557438, 59141/64XB01643//866572077557446//866572077557453, 59141/64XB01645//866572077557487//866572077557495, 59141/6
4XB01650//866572077566041//866572077566058, 59141/64XB01653//866572077566108//866572077566116, 59141/64XB01655//866572077566140//
866572077566157, 59141/64XB01659//866572077566223//866572077566231, 59141/64XB01662//866572077566280//866572077566298, 59141/64XB
01664//866572077566322//866572077566330, 59141/64XB01666//866572077566363//866572077566371, 59141/64XB01667//866572077566389//866
572077566397, 59141/64XB01672//866572077566488//866572077566496, 59141/64XB01673//866572077566504//866572077566512, 59141/64XB016
75//866572077566546//866572077566553, 59141/64XB01681//866572077566660//866572077566678, 59141/64XB01687//866572077566785//866572
077566793, 59141/64XB01688//866572077566801//866572077566819, 59141/64XB01689//866572077566827//866572077566835, 59141/64XB01690/
/866572077566843//866572077566850, 59141/64XB01723//866572077573740//866572077573757, 59141/64XB01732//866572077566868//866572077
566876, 59141/64XB01739//866572077567007//866572077567015, 59141/64XB01740//866572077567023//866572077567031, 59141/64XB01741//86
6572077567049//866572077567056, 59141/64XB01743//866572077567080//866572077567098, 59141/64XB01746//866572077567148//866572077567
155, 59141/64XB01747//866572077567163//866572077567171, 59141/64XB01748//866572077567189//866572077567197, 59141/64XB01749//86657
2077567205//866572077567213, 59141/64XB01751//866572077567247//866572077567254, 59141/64XB01753//866572077567288//866572077567296
, 59141/64XB01755//866572077567320//866572077567338, 59141/64XB01756//866572077567346//866572077567353, 59141/64XB01757//86657207
7567361//866572077567379, 59141/64XB01759//866572077567403//866572077567411, 59141/64XB01760//866572077567429//866572077567437, 5
9141/64XB01762//866572077567460//866572077567478, 59141/64XB01764//866572077567502//866572077567510, 59141/64XB01765//86657207756
7528//866572077567536, 59141/64XB01766//866572077567544//866572077567551, 59141/64XB01767//866572077567569//866572077567577, 5914
1/64XB01768//866572077567585//866572077567593, 59141/64XB01774//866572077567700//866572077567718, 59141/64XB01775//86657207756772
6//866572077567734, 59141/64XB01776//866572077567742//866572077567759, 59141/64XB01782//866572077567866//866572077567874, 59141/6
4XB01785//866572077567924//866572077567932, 59141/64XB01787//866572077567965//866572077567973, 59141/64XB01788//866572077567981//
866572077567999, 59141/64XB01789//866572077568005//866572077568013, 59141/64XB01790//866572077568021//866572077568039, 59141/64XB
01791//866572077568047//866572077568054, 59141/64XB01796//866572077568146//866572077568153, 59141/64XB01797//866572077568161//866
572077568179, 59141/64XB01799//866572077568203//866572077568211, 59141/64XB01800//866572077568229//866572077568237, 59141/64XB018
02//866572077568260//866572077568278, 59141/64XB01804//866572077568302//866572077568310, 59141/64XB01806//866572077568344//866572
077568351, 59141/64XB01808//866572077568385//866572077568393, 59141/64XB01809//866572077568401//866572077568419, 59141/64XB01810/
/866572077568427//866572077568435, 59141/64XB01811//866572077568443//866572077568450, 59141/64XB01812//866572077568468//866572077
568476, 59141/64XB01813//866572077568484//866572077568492, 59141/64XB01855//866572077568500//866572077568518, 59141/64XB01856//86
6572077568526//866572077568534, 59141/64XB01857//866572077568542//866572077568559, 59141/64XB01858//866572077568567//866572077568
575, 59141/64XB01859//866572077568583//866572077568591, 59141/64XB01861//866572077568625//866572077568633, 59141/64XB01862//86657
2077568641//866572077568658, 59141/64XB01863//866572077568666//866572077568674, 59141/64XB01864//866572077568682//866572077568690
, 59141/64XB01865//866572077568708//866572077568716, 59141/64XB01866//866572077568724//866572077568732, 59141/64XB01867//86657207
7568740//866572077568757, 59141/64XB01868//866572077568765//866572077568773, 59141/64XB01869//866572077568781//866572077568799, 5
9141/64XB01870//866572077568807//866572077568815, 59141/64XB01871//866572077568823//866572077568831, 59141/64XB01872//86657207756
8849//866572077568856, 59141/64XB01873//866572077568864//866572077568872, 59141/64XB01874//866572077568880//866572077568898, 5914
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8//866572077568955, 59141/64XB01878//866572077568963//866572077568971, 59141/64XB01879//866572077568989//866572077568997, 59141/6
4XB01880//866572077569003//866572077569011, 59141/64XB01881//866572077569029//866572077569037, 59141/64XB01883//866572077569060//
866572077569078, 59141/64XB01884//866572077569086//866572077569094, 59141/64XB01887//866572077569144//866572077569151, 59141/64XB
01891//866572077569227//866572077569235, 59141/64XB01892//866572077569243//866572077569250, 59141/64XB01893//866572077569268//866
572077569276, 59141/64XB01894//866572077569284//866572077569292, 59141/64XB01895//866572077569300//866572077569318, 59141/64XB019
37//866572077569326//866572077569334, 59141/64XB01940//866572077569383//866572077569391, 59141/64XB01942//866572077569425//866572
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, 59141/64XB01970//866572077569987//866572077569995, 59141/64XB01971//866572077570001//866572077570019, 59141/64XB01972//86657207
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0320240016634593
Espacio para uso exclusivo de la Entidad
Recaudadora
REPÚBLICA DE COLOMBIA
Declaración
de
Importación
Aceptación :
0320240016634593
Subpartida :
8517130000
Página 2 de 7
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
115117, 59141/64XK05202//867070076131304//867070076131312, 59141/64XK05213//867070076116123//867070076116131, 59141/64XK05854//86
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218, 59141/64XK06029//867070076341705//867070076341713, 59141/64XK06059//867070076343149//867070076343156, 59141/64XK06650//86707
0076358261//867070076358279, 59141/64XK06683//867070076342182//867070076342190, 59141/64XK06690//867070076342323//867070076342331
, 59141/64XK06721//867070076359749//867070076359756, 59141/64XK07199//867070076373427//867070076373435, 59141/64XK07337//86707007
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6909//867070076376917, 59141/64XK07390//867070076377022//867070076377030, 59141/64XK07392//867070076377063//867070076377071, 5914
1/64XK07537//867070076364368//867070076364376, 59141/64XK07540//867070076364426//867070076364434, 59141/64XK07543//86707007636448
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0320240016634593
Espacio para uso exclusivo de la Entidad
Recaudadora
REPÚBLICA DE COLOMBIA
Declaración
de
Importación
Aceptación :
0320240016634593
Subpartida :
8517130000
Página 3 de 7
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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0320240016634593
Espacio para uso exclusivo de la Entidad
Recaudadora
REPÚBLICA DE COLOMBIA
Declaración
de
Importación
Aceptación :
0320240016634593
Subpartida :
8517130000
Página 6 de 7
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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0320240016634593
Espacio para uso exclusivo de la Entidad
Recaudadora
REPÚBLICA DE COLOMBIA
Declaración
de
Importación
Aceptación :
0320240016634593
Subpartida :
8517130000
Página 7 de 7
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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