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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
032024001827810-1
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. 116575015122286
43 . Año – Mes – Día
2024 – 12 – 27
44 . Documento de transporte
No. 41N0674467
45 . Año – Mes – Día
2024 – 12 – 20
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
6900326770
52 . Año – Mes – Día
2024 – 12 – 17
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.
4.375.86
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.
138.00
72 . Peso neto kgs. dcms.
105.60
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
27.916.12
79 . Valor fletes USD
1.112.28 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
127.030.384
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
127.030.384
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
1.41
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.113.69
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
29.029.81
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: 542489-DECL: 1872079-DO: 893130524241- 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: 3079837157. ID DELIVERY: 6079641902. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A057MZKHLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05S DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, 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
032024001827810
133. Feha: 202412 30
134 . Levante No. 032024001736100 135 . Fecha
2024 – 12 – 30
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 92032409706764
Fecha presentación 2024-12-30 10:47:28
Valor pagado $0.00
Fecha de Impresión: 2024-12-30 10:47:33
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001827810-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A057M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A057M/DS,BLACK,LTC( QTY. 400,00 u )(400,00 PCE);
IMEIS: 350290619205050/355253229205055. 350290619205068/355253229205063. 350290619205076/355253229205071. 350290619205084/355253
229205089. 350290619205092/355253229205097. 350290619205100/355253229205105. 350290619205118/355253229205113. 350290619205126/355
253229205121. 350290619205134/355253229205139. 350290619205142/355253229205147. 350290619205159/355253229205154. 350290619205167/
355253229205162. 350290619206827/355253229206822. 350290619206868/355253229206863. 350290619206918/355253229206913. 3502906192070
23/355253229207028. 350290619207031/355253229207036. 350290619207049/355253229207044. 350290619207056/355253229207051. 3502906192
07064/355253229207069. 350290619207098/355253229207093. 350290619207106/355253229207101. 350290619207114/355253229207119. 3502906
19207122/355253229207127. 350290619207130/355253229207135. 350290619207197/355253229207192. 3 50290619207221/355253229207226. 350
290619207254/355253229207259. 350290619207270/355253229207275. 350290619207288/355253229207283. 350290619207304/355253229207309.
350290619207312/355253229207317. 350290619207411/355253229207416. 350290619207478/355253229207473. 350290619207510/35525322920751
5. 350290619207577/355253229207572. 350290619207601/355253229207606. 350290619207627/355253229207622. 350290619207643/35525322920
7648. 350290619207650/355253229207655. 350290619207676/355253229207671. 350290619207692/355253229207697. 350290619207718/35525322
9207713.350290619207726/355253229207721. 350290619207734/355253229207739. 350290619207767/355253229207762. 350290619207940/355253
229207945. 350290619208047/355253229208042. 350290619208054/355253229208059. 350290619208195/355253229208190. 350290619208377/355
253229208372. 350290619208401/355253229208406. 350290619208682/355253229208687. 350290619208807/355253229208802. 350290619208823/
355253229208828. 350290619208971/355253229208976. 350290619209128/355253229209123. 350290619209300/355253229209305. 3502906192093
18/355253229209313. 350290619209342/355253229209347.350290619209367/355253229209362. 350290619209425/355253229209420. 35029061920
9573/355253229209578. 350290619209706/355253229209701. 350290619209722/355253229209727. 350290619209748/355253229209743. 35029061
9209763/355253229209768. 350290619209797/355253229209792. 350290619209805/355253229209800. 350290619209896/355253229209891. 35029
0619209953/355253229209958. 350290619210183/355253229210188. 350290619210423/355253229210428. 350290619210456/355253229210451. 35
0290619210472/355253229210477. 350290619210662/355253229210667. 350290619210688/355253229210683. 350290619210696/355253229210691.
350290619210712/355253229210717. 350290619210738/355253229210733. 350290619210829/355253229210824. 350290619210951/3552532292109
56. 350290619210969/355253229210964. 350290619210993/355253229210998. 350290619211009/355253229211004. 350290619211017/3552532292
11012. 350290619211033/355253229211038. 350290619211041/355253229211046. 350290619211058/355253229211053. 350290619211082/3552532
29211087. 350290619211116/355253229211111. 350290619211132/355253229211137. 350290619211157/355253229211152. 350290619211165/3552
53229211160. 350290619211199/355253229211194. 350290619211207/355253229211202. 350290619211215/355253229211210. 350290619211272/3
55253229211277. 350290619211330/355253229211335. 350290619211348/355253229211343. 350290619211355/355253229211350. 35029061921136
3/355253229211368. 350290619211389/355253229211384. 350290619211405/355253229211400. 350290619211413/355253229211418. 35029061921
1421/355253229211426. 350290619211439/355253229211434. 350290619211454/355253229211459. 350290619211462/355253229211467. 35029061
9211488/355253229211483. 350290619211496/355253229211491. 350290619211512/355253229211517. 350290619211546/355253229211541.350290
619211553/355253229211558. 350290619211561/355253229211566. 350290619211579/355253229211574. 350290619211587/355253229211582. 350
290619211595/355253229211590. 350290619211611/355253229211616. 350290619211835/355253229211830. 350290619211868/355253229211863.
350290619211892/355253229211897. 350290619212049/355253229212044. 350290619212106/355253229212101. 350290619212130/35525322921213
5. 350290619212254/355253229212259. 350290619212270/355253229212275. 350290619212320/355253229212325. 350290619212346/35525322921
2341. 350290619212395/355253229212390.350290619212429/355253229212424. 350290619212452/355253229212457. 350290619212494/355253229
212499. 350290619212544/355253229212549. 350290619212569/355253229212564. 350290619195418/355253229195413. 350290619195608/355253
229195603. 350290619195707/355253229195702. 350290619196168/355253229196163. 350290619196234/355253229196239. 350290619196242/355
253229196247. 350290619196259/355253229196254. 350290619196267/355253229196262. 350290619196275/355253229196270. 350290619196283/
355253229196288. 350290619196291/355253229196296. 350290619196309/355253229196304. 350290619196325/355253229196320. 3502906191963
33/355253229196338. 350290619196341/355253229196346. 350290619196358/355253229196353. 350290619196366/355253229196361. 3502906191
96374/355253229196379. 350290619196382/355253229196387. 350290619196408/355253229196403. 350290619196416/355253229196411. 3502906
19196424/355253229196429. 350290619196440/355253229196445. 350290619196465/355253229196460. 350290619196473/355253229196478. 3502
90619196481/355253229196486. 350290619196499/355253229196494. 350290619196507/355253229196502. 350290619196515/355253229196510. 3
50290619196523/355253229196528. 350290619196531/355253229196536. 350290619196564/355253229196569. 350290619196572/355253229196577
. 350290619196598/355253229196593. 350290619196606/355253229196601. 350290619196622/355253229196627. 350290619196630/355253229196
635. 350290619196655/355253229196650. 350290619196671/355253229196676. 350290619196705/355253229196700. 350290619196739/355253229
196734. 350290619196747/355253229196742. 350290619196770/355253229196775. 350290619196788/355253229196783. 350290619196796/355253
229196791. 350290619196804/355253229196809. 350290619196812/355253229196817. 350290619196838/355253229196833.350290619196853/3552
53229196858. 350290619196861/355253229196866. 350290619196879/355253229196874. 350290619196887/355253229196882. 350290619196895/3
55253229196890. 350290619196903/355253229196908. 350290619196911/355253229196916. 350290619196929/355253229196924. 35029061919694
5/355253229196940. 350290619196952/355253229196957. 350290619196960/355253229196965. 350290619196978/355253229196973. 35029061919
6986/355253229196981. 350290619196994/355253229196999. 350290619197000/355253229197005. 350290619197026/355253229197021. 35029061
9197034/355253229197039.350290619197059/355253229197054. 350290619197109/355253229197104. 350290619197133/355253229197138. 350290
619197141/355253229197146. 350290619197166/355253229197161. 350290619197174/355253229197179. 350290619197216/355253229197211. 350
290619197315/355253229197310. 350290619197497/355253229197492. 350290619197505/355253229197500. 350290619197521/355253229197526.
350290619197604/355253229197609. 350290619197695/355253229197690. 350290619197711/355253229197716. 350290619197729/35525322919772
4. 350290619197737/355253229197732. 350290619197752/355253229197757. 350290619197786/355253229197781. 350290619197802/35525322919
7807. 350290619197828/355253229197823. 350290619197836/355253229197831. 350290619197851/355253229197856. 350290619197869/35525322
9197864. 350290619197877/355253229197872. 350290619197885/355253229197880. 350290619197893/355253229197898. 350290619197901/35525
3229197906. 350290619197919/355253229197914. 350290619197927/355253229197922. 350290619197935/355253229197930. 350290619197943/35
5253229197948. 350290619197968/355253229197963. 350290619197976/355253229197971. 350290619197984/355253229197989. 350290619197992
/355253229197997. 350290619198008/355253229198003. 350290619198016/355253229198011. 350290619198024/355253229198029. 350290619198
032/355253229198037. 350290619198057/355253229198052. 350290619198065/355253229198060. 350290619198073/355253229198078. 350290619
198081/355253229198086. 350290619198099/355253229198094. 350290619198107/355253229198102. 350290619198115/355253229198110. 350290
619198123/355253229198128. 350290619198131/355253229198136. 350290619198149/355253229198144. 350290619198156/355253229198151. 350
290619198164/355253229198169. 350290619198172/355253229198177. 350290619198180/355253229198185.350290619198198/355253229198193. 3
50290619198214/355253229198219. 350290619198222/355253229198227. 350290619198230/355253229198235. 350290619198248/355253229198243
. 350290619198255/355253229198250. 350290619198263/355253229198268. 350290619198271/355253229198276. 350290619198289/355253229198
284. 350290619198305/355253229198300. 350290619198313/355253229198318. 350290619198347/355253229198342. 350290619198354/355253229
198359. 350290619198362/355253229198367. 350290619198396/355253229198391. 350290619198412/355253229198417. 350290619200556/355253
229200551.350290619203915/355253229203910. 350290619203931/355253229203936. 350290619203956/355253229203951. 350290619203998/3552
53229203993. 350290619204061/355253229204066. 350290619204285/355253229204280. 350290619204335/355253229204330. 350290619204350/3
55253229204355. 350290619204384/355253229204389. 350290619204392/355253229204397. 350290619204400/355253229204405. 35029061920442
6/355253229204421. 350290619204442/355253229204447. 350290619204459/355253229204454. 350290619204525/355253229204520. 35029061920
4533/355253229204538. 350290619204541/355253229204546. 350290619204566/355253229204561. 350290619204574/355253229204579. 35029061
032024001827810-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032024001827810-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
9204608/355253229204603. 350290619204616/355253229204611. 350290619204624/355253229204629. 350290619204756/355253229204751. 35029
0619204822/355253229204827. 350290619204830/355253229204835. 350290619204855/355253229204850. 350290619204863/355253229204868. 35
0290619204871/355253229204876. 350290619204889/355253229204884. 350290619204897/355253229204892. 350290619204905/355253229204900.
350290619204913/355253229204918. 350290619204921/355253229204926. 350290619204939/355253229204934. 350290619204947/3552532292049
42. 350290619204954/355253229204959. 350290619204962/355253229204967. 350290619204970/355253229204975. 350290619204988/3552532292
04983. 350290619204996/355253229204991. 350290619205001/355253229205006. 350290619205019/355253229205014. 350290619205027/3552532
29205022. 350290619205035/355253229205030. 350290619205043/355253229205048. 350290619200739/355253229200734. 350290619200788/3552
53229200783. 350290619200887/355253229200882. 350290619200994/355253229200999. 350290619201182/355253229201187. 350290619201224/3
55253229201229. 350290619201240/355253229201245. 350290619201257/355253229201252.350290619201307/355253229201302. 350290619201315
/355253229201310. 350290619201349/355253229201344. 350290619201620/355253229201625. 350290619202172/355253229202177. 350290619202
206/355253229202201. 350290619202313/355253229202318. 350290619202321/355253229202326. 350290619202362/355253229202367. 350290619
202370/355253229202375. 350290619202602/355253229202607. 350290619202701/355253229202706. 350290619202727/355253229202722. 350290
619202743/355253229202748. 350290619202826/355253229202821. 350290619202875/355253229202870. 350290619202982/355253229202987.3502
90619203071/355253229203076. 350290619203121/355253229203126. 350290619203147/355253229203142. 350290619203162/355253229203167. 3
50290619203196/355253229203191. 350290619203220/355253229203225. 350290619203246/355253229203241. 350290619203253/355253229203258
. 350290619203261/355253229203266. 350290619203279/355253229203274. 350290619203303/355253229203308. 350290619203402/355253229203
407. 350290619203519/355253229203514. 350290619203691/355253229203696. 350290619203782/355253229203787. 350290619203790/355253229
203795. 350290619203816/355253229203811. 350290619203824/355253229203829. 350290619203832/355253229203837. 350290619203857/355253
229203852. 350290619212643/355253229212648. 350290619212650/355253229212655. 350290619212668/355253229212663. 350290619212676/355
253229212671. 350290619212684/355253229212689. 350290619212692/355253229212697. 350290619212700/355253229212705. 350290619212718/
355253229212713. 350290619212734/355253229212739. 350290619212742/355253229212747. 350290619212759/355253229212754. 3502906192127
67/355253229212762. 350290619212791/355253229212796. 350290619212809/355253229212804. 350290619212817/355253229212812. 3502906192
12825/355253229212820. 350290619212833/355253229212838. 350290619212858/355253229212853. 350290619212866/355253229212861. 3502906
19212882/355253229212887. 350290619212908/355253229212903. 350290619212916/355253229212911. 350290619212924/355253229212929. 3502
90619212957/355253229212952. 350290619212973/355253229212978. 350290619212981/355253229212986. 350290619212999/355253229212994. 3
50290619213013/355253229213018. 350290619213039/355253229213034. 350290619213070/355253229213075. 350290619213088/355253229213083
. 350290619213096/355253229213091. 350290619213104/355253229213109.350290619213112/355253229213117. 350290619213120/3552532292131
25. 350290619213138/355253229213133. 350290619213146/355253229213141. 350290619213161/355253229213166. 350290619213187/3552532292
13182. 350290619213195/355253229213190XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032024001827810-1
Espacio para uso exclusivo de la Entidad Recaudadora
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