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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
032024001697067-6
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
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. 116575015048101
43 . Año – Mes – Día
2024 – 12 – 04
44 . Documento de transporte
No. 41N0684642
45 . Año – Mes – Día
2024 – 11 – 27
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
6900318970
52 . Año – Mes – Día
2024 – 11 – 19
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.
4.406.16
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.
136.00
72 . Peso neto kgs. dcms.
105.69
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
390.00
78 .Valor FOB
USD
18.807.29
79 . Valor fletes USD
1.096.16 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
87.702.015
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
87.702.015
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
0.96
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.097.12
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
19.904.41
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: 540140-DECL: 1864272-DO: 893128967241- 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 R
ESOLUCIÓN 5050 DEL 10DE NOVIEMBRE DE 2016. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN)/ NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANC
IA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3078526043. ID DELIVERY:
6079281417. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZKGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA
USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, MODELO:SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL(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
032024001697067
133. Feha: 202412 03
134 . Levante No. 032024001628814 135 . Fecha
2024 – 12 – 05
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 92032409039108
Fecha presentación 2024-12-03 16:22:00
Valor pagado $0.00
Fecha de Impresión: 2024-12-05 14:19:13
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001697067-6
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DETAL/ /MOBILE,SM-A055M/DS,BLACK,LTC( QTY. 390,00 u )(390,00 PCE); IMEIS: 351641241791124/351847821791125. 351641241791231/35184
7821791232. 351641241791249/351847821791240. 351641241791710/351847821791711. 351641241791926/351847821791927. 351641241791934/35
1847821791935. 351641241791942/351847821791943. 351641241791967/351847821791968. 351641241791975/351847821791976. 351641241791983
/351847821791984. 351641241791991/351847821791992. 351641241792007/351847821792008. 351641241792015/351847821792016.3516412417920
23/351847821792024. 351641241792031/351847821792032. 351641241792049/351847821792040. 351641241792056/351847821792057. 3516412417
92064/351847821792065. 351641241792072/351847821792073. 351641241792106/351847821792107. 351641241792114/351847821792115. 3516412
41792262/351847821792263. 351641241792338/351847821792339. 351641241792346/351847821792347. 351641241792353/351847821792354. 3516
41241792361/351847821792362. 351641241792403/351847821792404. 351641241792429/351847821792 420. 351641241792445/351847821792446.
351641241792452/351847821792453.351641241792510/351847821792511. 351641241792536/351847821792537. 351641241792619/351847821792610
. 351641241792635/351847821792636. 351641241792692/351847821792693. 351641241792718/351847821792719. 351641241792783/351847821792
784. 351641241792825/351847821792826. 351641241793120/351847821793121. 351641241793138/351847821793139. 351641241793153/351847821
793154. 351641241793476/351847821793477. 351641241793534/351847821793535. 351641241793559/351847821793550. 351641241793583/351847
821793584. 351641241778428/351847821778429. 351641241778477/351847821778478. 351641241778519/351847821778510. 351641241779079/351
847821779070. 351641241779467/351847821779468. 351641241779616/351847821779617. 351641241779715/351847821779716. 351641241779731/
351847821779732. 351641241779772/351847821779773. 351641241779780/351847821779781. 351641241779798/351847821779799. 3516412417798
22/351847821779823. 351641241779913/351847821779914. 351641241779921/351847821779922. 351641241779970/351847821779971. 3516412417
79988/351847821779989. 351641241780044/351847821780045. 351641241780119/351847821780110. 351641241780184/351847821780185. 3516412
41780275/351847821780276. 351641241780309/351847821780300. 351641241780481/351847821780482. 351641241780564/351847821780565. 3516
41241780572/351847821780573. 351641241780606/351847821780607. 351641241780663/351847821780664. 351641241780713/351847821780714. 3
51641241780721/351847821780722. 351641241780788/351847821780789. 351641241780937/351847821780938. 351641241780952/351847821780953
. 351641241781091/351847821781092. 351641241781141/351847821781142. 351641241781364/351847821781365. 351641241781422/351847821781
423. 351641241781448/351847821781449. 351641241781463/351847821781464. 351641241781489/351847821781480.351641241781547/3518478217
81548. 351641241781729/351847821781720. 351641241781935/351847821781936. 351641241781950/351847821781951. 351641241781976/3518478
21781977. 351641241782131/351847821782132. 351641241782156/351847821782157. 351641241782289/351847821782280. 351641241782420/3518
47821782421. 351641241782677/351847821782678. 351641241782925/351847821782926. 351641241783972/351847821783973. 351641241784483/3
51847821784484. 351641241784566/351847821784567. 351641241784707/351847821784708. 351641241784848/351847821784849. 35164124178538
1/351847821785382.351641241785498/351847821785499. 351641241785746/351847821785747. 351641241785779/351847821785770. 351641241785
803/351847821785804. 351641241785886/351847821785887. 351641241785944/351847821785945. 351641241786140/351847821786141. 351641241
786165/351847821786166. 351641241786272/351847821786273. 351641241786306/351847821786307. 351641241786363/351847821786364. 351641
241786405/351847821786406. 351641241786413/351847821786414. 351641241786462/351847821786463. 351641241786579/351847821786570. 351
641241786652/351847821786653. 351641241786686/351847821786687. 351641241786702/351847821786703. 351641241786793/351847821786794.
351641241787353/351847821787354. 351641241787866/351847821787867. 351641241787965/351847821787966. 351641241788260/35184782178826
1. 351641241788344/351847821788345. 351641241788351/351847821788352. 351641241788377/351847821788378. 351641241788401/35184782178
8402. 351641241788435/351847821788436. 351641241788476/351847821788477. 351641241788518/351847821788519. 351641241788591/35184782
1788592. 351641241788633/351847821788634. 351641241788666/351847821788667. 351641241788708/351847821788709. 351641241788732/35184
7821788733. 351641241788765/351847821788766. 351641241788799/351847821788790. 351641241788807/351847821788808. 351641241788815/35
1847821788816. 351641241788831/351847821788832. 351641241788849/351847821788840. 351641241788856/351847821788857. 351641241788872
/351847821788873. 351641241788898/351847821788899. 351641241788906/351847821788907. 351641241788914/351847821788915. 351641241788
922/351847821788923. 351641241788930/351847821788931. 351641241788948/351847821788949. 351641241788955/351847821788956. 351641241
788963/351847821788964. 351641241788989/351847821788980. 351641241789029/351847821789020.351641241789052/351847821789053. 3516412
41789060/351847821789061. 351641241789078/351847821789079. 351641241789086/351847821789087. 351641241789094/351847821789095. 3516
41241789151/351847821789152. 351641241789185/351847821789186. 351641241789193/351847821789194. 351641241789227/351847821789228. 3
51641241789243/351847821789244. 351641241789326/351847821789327. 351641241789359/351847821789350. 351641241789367/351847821789368
. 351641241789375/351847821789376. 351641241789383/351847821789384. 351641241789391/351847821789392. 351641241789425/351847821789
426.351641241789474/351847821789475. 351641241789524/351847821789525. 351641241789573/351847821789574. 351641241789607/3518478217
89608. 351641241789615/351847821789616. 351641241789649/351847821789640. 351641241789656/351847821789657. 351641241789664/3518478
21789665. 351641241789672/351847821789673. 351641241789680/351847821789681. 351641241789706/351847821789707. 351641241789722/3518
47821789723. 351641241789847/351847821789848. 351641241789979/351847821789970. 351641241790050/351847821790051. 351641241790175/3
51847821790176. 351641241790233/351847821790234. 351641241790241/351847821790242. 351641241790324/351847821790325. 35164124179037
3/351847821790374. 351641241790415/351847821790416. 351641241790423/351847821790424. 351641241790431/351847821790432. 35164124179
0456/351847821790457. 351641241790464/351847821790465. 351641241790472/351847821790473. 351641241790498/351847821790499. 35164124
1790522/351847821790523. 351641241790530/351847821790531. 351641241790555/351847821790556. 351641241790571/351847821790572. 35164
1241790613/351847821790614. 351641241790621/351847821790622. 351641241790647/351847821790648. 351641241790654/351847821790655. 35
1641241790696/351847821790697. 351641241790720/351847821790721. 351641241790738/351847821790739. 351641241790795/351847821790796.
351641241790811/351847821790812. 351641241790837/351847821790838. 351641241790845/351847821790846. 351641241790852/3518478217908
53. 351641241790886/351847821790887. 351641241790902/351847821790903. 351641241790910/351847821790911. 351641241790944/3518478217
90945. 351641241790951/351847821790952. 351641241790969/351847821790960. 351641241790993/351847821790994. 351641241791025/3518478
21791026. 351641241791041/351847821791042. 351641241791074/351847821791075.351641241791082/351847821791083. 351641241791108/35184
7821791109. 351641241793617/351847821793618. 351641241793625/351847821793626. 351641241793641/351847821793642. 351641241793658/35
1847821793659. 351641241793708/351847821793709. 351641241793732/351847821793733. 351641241793740/351847821793741. 351641241793757
/351847821793758. 351641241793765/351847821793766. 351641241793773/351847821793774. 351641241793781/351847821793782. 351641241793
799/351847821793790. 351641241793807/351847821793808. 351641241793815/351847821793816. 351641241793849/351847821793840.3516412417
93856/351847821793857. 351641241793864/351847821793865. 351641241793872/351847821793873. 351641241793880/351847821793881. 3516412
41793898/351847821793899. 351641241793914/351847821793915. 351641241793922/351847821793923. 351641241793948/351847821793949. 3516
41241793997/351847821793998. 351641241794003/351847821794004. 351641241794011/351847821794012. 351641241794029/351847821794020. 3
51641241794086/351847821794087. 351641241794094/351847821794095. 351641241794128/351847821794129. 351641241794136/351847821794137
. 351641241794144/351847821794145. 351641241794169/351847821794160. 351641241794227/351847821794228. 351641241794235/351847821794
236. 351641241794243/351847821794244. 351641241794284/351847821794285. 351641241794318/351847821794319. 351641241794383/351847821
794384. 351641241794409/351847821794400. 351641241794425/351847821794426. 351641241794441/351847821794442. 351641241794458/351847
821794459. 351641241794474/351847821794475. 351641241794599/351847821794590. 351641241794615/351847821794616. 351641241794623/351
847821794624. 351641241794631/351847821794632. 351641241794649/351847821794640. 351641241794656/351847821794657. 351641241794698/
351847821794699. 351641241794714/351847821794715. 351641241794722/351847821794723. 351641241794730/351847821794731. 3516412417947
55/351847821794756. 351641241794763/351847821794764. 351641241794771/351847821794772. 351641241794854/351847821794855. 3516412417
94862/351847821794863. 351641241794896/351847821794897. 351641241794904/351847821794905. 351641241794920/351847821794921. 3516412
41794938/351847821794939. 351641241794946/351847821794947. 351641241794953/351847821794954. 351641241794961/351847821794962. 3516
032024001697067-6
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001697067-6
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
41241794987/351847821794988. 351641241794995/351847821794996.351641241795018/351847821795019. 351641241795067/351847821795068. 35
1641241795083/351847821795084. 351641241795109/351847821795100. 351641241795117/351847821795118. 351641241795166/351847821795167.
351641241795182/351847821795183. 351641241795190/351847821795191. 351641241795208/351847821795209. 351641241795216/3518478217952
17. 351641241795224/351847821795225. 351641241795232/351847821795233. 351641241795240/351847821795241. 351641241795265/3518478217
95266. 351641241795273/351847821795274. 351641241795281/351847821795282. 351641241795299/351847821795290.351641241795307/35184782
1795308. 351641241795315/351847821795316. 351641241795323/351847821795324. 351641241795331/351847821795332. 351641241795349/35184
7821795340. 351641241795356/351847821795357. 351641241795380/351847821795381. 351641241795398/351847821795399. 351641241795414/35
1847821795415. 351641241795430/351847821795431. 351641241795448/351847821795449. 351641241795463/351847821795464. 351641241795489
/351847821795480. 351641241795513/351847821795514. 351641241795521/351847821795522. 351641241795547/351847821795548. 351641241795
554/351847821795555. 351641241795562/351847821795563. 351641241795570/351847821795571. 351641241795638/351847821795639. 351641241
795661/351847821795662. 351641241795695/351847821795696. 351641241795729/351847821795720. 351641241795737/351847821795738. 351641
241795778/351847821795779. 351641241795828/351847821795829. 351641241795935/351847821795936. 351641241796032/351847821796033. 351
641241796156/351847821796157. 351641241796164/351847821796165. 351641241796172/351847821796173. 351641241796180/351847821796181.
351641241796198/351847821796199. 351641241796255/351847821796256. 351641241796263/351847821796264. 351641241796271/35184782179627
2. 351641241796289/351847821796280. 351641241796297/351847821796298. 351641241796305/351847821796306. 351641241796313/35184782179
6314. 351641241796339/351847821796330. 351641241796347/351847821796348. 351641241796362/351847821796363. 351641241796370/35184782
1796371. 351641241796388/351847821796389. 351641241796396/351847821796397. 351641241796404/351847821796405. 351641241796412/35184
7821796413. 351641241796420/351847821796421. 351641241796438/351847821796439. 351641241796446/351847821796447. 351641241796453/35
1847821796454. 351641241796461/351847821796462.351641241796479/351847821796470. 351641241796487/351847821796488. 351641241796495/
351847821796496. 351641241796503/351847821796504. 351641241796511/351847821796512. 351641241796529/351847821796520. 3516412417965
37/351847821796538. 351641241796545/351847821796546. 351641241796552/351847821796553. 351641241796560/351847821796561. 3516412417
96602/351847821796603. 351641241796610/351847821796611. 351641241796628/351847821796629. 351641241796644/351847821796645. 3516412
41796685/351847821796686. 351641241796701/351847821796702. 351641241796719/351847821796710.351641241796842/351847821796843. 35164
1241796859/351847821796850. 351641241796891/351847821796892. 351641241796909/351847821796900. 351641241796925/351847821796926. 35
1641241796958/351847821796959. 351641241797170/351847821797171. 351641241797188/351847821797189. 351641241797204/351847821797205.
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032024001697067-6
Espacio para uso exclusivo de la Entidad Recaudadora
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