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REPÚBLICA DE COLOMBIA
Declaración de Importación Privada 500
1. Año 2025
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032025000023666-3
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. 116575015145075
43 . Año – Mes – Día
2025 – 01 – 07
44 . Documento de transporte
No. T61725Q0055
45 . Año – Mes – Día
2024 – 12 – 30
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
6900328689
52 . Año – Mes – Día
2024 – 12 – 26
53 . Cod. país
procedencia
215
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
580
56 . Cod. Depto
destino
0
57 . Empresa transportadora
DHL AERO EXPRESO S A SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.410.50
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.
109.00
72 . Peso neto kgs. dcms.
79.20
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
300.00
78 .Valor FOB
USD
20.669.45
79 . Valor fletes USD
930.86 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
95.272.798
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
95.272.798
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
1.05
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
931.91
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
21.601.36
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: 543091-DECL: 1873319-DO: 893100100251- 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: 3080694826. ID DELIVERY: 6079750962. 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
032025000023666
133. Feha: 202501 08
134 . Levante No. 032025000021406 135 . Fecha
2025 – 01 – 08
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 92032500143687
Fecha presentación 2025-01-08 12:23:23
Valor pagado $0.00
Fecha de Impresión: 2025-01-08 12:23:28
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000023666-3
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. 300,00 u )(300,00 PCE);
IMEIS: 350290619370458/355253229370453. 350290619370581/355253229370586. 350290619370730/355253229370735. 350290619370938/355253
229370933. 350290619370995/355253229370990. 350290619372561/355253229372566. 350290619373205/355253229373200. 350290619373239/355
253229373234. 350290619374112/355253229374117. 350290619376562/355253229376567. 350290619376570/355253229376575. 350290619376810/
355253229376815. 350290619376893/355253229376898. 350290619376968/355253229376963. 350290619379194/355253229379199. 3502906193795
33/355253229379538. 350290619382289/355253229382284. 350290619382396/355253229382391. 350290619382438/355253229382433. 3502906193
82636/355253229382631. 350290619382644/355253229382649. 350290619382701/355253229382706. 350290619382727/355253229382722. 3502906
19382735/355253229382730. 350290619384129/355253229384124. 350290619385944/355253229385949. 3 50290619387502/355253229387507. 350
290619387627/355253229387622. 350290619387817/355253229387812. 350290619388781/355253229388786. 350290619388864/355253229388869.
350290619388906/355253229388901. 350290619390217/355253229390212. 350290619390605/355253229390600. 350290619393336/35525322939333
1. 350290619393625/355253229393620. 350290619393641/355253229393646. 350290619393708/355253229393703. 350290619393831/35525322939
3836. 350290619395075/355253229395070. 350290619398673/355253229398678. 350290619398970/355253229398975. 350290619399036/35525322
9399031.350290619399085/355253229399080. 350290619399119/355253229399114. 350290619399127/355253229399122. 350290619399135/355253
229399130. 350290619399143/355253229399148. 350290619399150/355253229399155. 350290619399168/355253229399163. 350290619399176/355
253229399171. 350290619399184/355253229399189. 350290619399192/355253229399197. 350290619399234/355253229399239. 350290619399259/
355253229399254. 350290619399267/355253229399262. 350290619399275/355253229399270. 350290619399283/355253229399288. 3502906193992
91/355253229399296. 350290619399309/355253229399304.350290619399317/355253229399312. 350290619399325/355253229399320. 35029061939
9333/355253229399338. 350290619399341/355253229399346. 350290619399358/355253229399353. 350290619399366/355253229399361. 35029061
9399374/355253229399379. 350290619399382/355253229399387. 350290619401543/355253229401548. 350290619404554/355253229404559. 35029
0619404570/355253229404575. 350290619405239/355253229405234. 350290619405304/355253229405309. 350290619405353/355253229405358. 35
0290619405379/355253229405374. 350290619405395/355253229405390. 350290619405429/355253229405424. 350290619405593/355253229405598.
350290619405858/355253229405853. 350290619407094/355253229407099. 350290619407102/355253229407107. 350290619407110/3552532294071
15. 350290619407128/355253229407123. 350290619407136/355253229407131. 350290619407144/355253229407149. 350290619407151/3552532294
07156. 350290619407169/355253229407164. 350290619407177/355253229407172. 350290619407185/355253229407180. 350290619407193/3552532
29407198. 350290619407201/355253229407206. 350290619407219/355253229407214. 350290619407227/355253229407222. 350290619407235/3552
53229407230. 350290619407243/355253229407248. 350290619407250/355253229407255. 350290619407268/355253229407263. 350290619407276/3
55253229407271. 350290619407284/355253229407289. 350290619407292/355253229407297. 350290619407300/355253229407305. 35029061940731
8/355253229407313. 350290619407326/355253229407321. 350290619407334/355253229407339. 350290619407342/355253229407347. 35029061940
7359/355253229407354. 350290619407375/355253229407370. 350290619407383/355253229407388. 350290619407391/355253229407396. 35029061
9407409/355253229407404. 350290619407417/355253229407412. 350290619407425/355253229407420. 350290619407433/355253229407438.350290
619407458/355253229407453. 350290619407466/355253229407461. 350290619407474/355253229407479. 350290619407482/355253229407487. 350
290619407490/355253229407495. 350290619407508/355253229407503. 350290619407516/355253229407511. 350290619407524/355253229407529.
350290619407557/355253229407552. 350290619407565/355253229407560. 350290619407573/355253229407578. 350290619412003/35525322941200
8. 350290619412938/355253229412933. 350290619412961/355253229412966. 350290619413027/355253229413022. 350290619413035/35525322941
3030. 350290619413100/355253229413105.350290619413142/355253229413147. 350290619413159/355253229413154. 350290619413175/355253229
413170. 350290619413183/355253229413188. 350290619413209/355253229413204. 350290619413233/355253229413238. 350290619413258/355253
229413253. 350290619413266/355253229413261. 350290619413274/355253229413279. 350290619413282/355253229413287. 350290619413308/355
253229413303. 350290619414017/355253229414012. 350290619414413/355253229414418. 350290619414421/355253229414426. 350290619414439/
355253229414434. 350290619414447/355253229414442. 350290619414454/355253229414459. 350290619414470/355253229414475. 3502906194145
79/355253229414574. 350290619414587/355253229414582. 350290619414595/355253229414590. 350290619414710/355253229414715. 3502906194
14835/355253229414830. 350290619414843/355253229414848. 350290619414850/355253229414855. 350290619414868/355253229414863. 3502906
19414876/355253229414871. 350290619414884/355253229414889. 350290619414892/355253229414897. 350290619414900/355253229414905. 3502
90619414918/355253229414913. 350290619414926/355253229414921. 350290619414934/355253229414939. 350290619414959/355253229414954. 3
50290619414967/355253229414962. 350290619414975/355253229414970. 350290619414983/355253229414988. 350290619414991/355253229414996
. 350290619415006/355253229415001. 350290619415014/355253229415019. 350290619415022/355253229415027. 350290619415030/355253229415
035. 350290619415055/355253229415050. 350290619415063/355253229415068. 350290619415097/355253229415092. 350290619415121/355253229
415126. 350290619415139/355253229415134. 350290619415147/355253229415142. 350290619415154/355253229415159. 350290619415162/355253
229415167. 350290619415188/355253229415183. 350290619415196/355253229415191. 350290619415204/355253229415209.350290619415212/3552
53229415217. 350290619415220/355253229415225. 350290619415246/355253229415241. 350290619415253/355253229415258. 350290619415261/3
55253229415266. 350290619415287/355253229415282. 350290619415295/355253229415290. 350290619415303/355253229415308. 35029061941531
1/355253229415316. 350290619415329/355253229415324. 350290619415337/355253229415332. 350290619415345/355253229415340. 35029061941
5352/355253229415357. 350290619417648/355253229417643. 350290619417911/355253229417916. 350290619418430/355253229418435. 35029061
9419016/355253229419011.350290619419990/355253229419995. 350290619420220/355253229420225. 350290619420329/355253229420324. 350290
619421137/355253229421132. 350290619421160/355253229421165. 350290619421186/355253229421181. 350290619421194/355253229421199. 350
290619421202/355253229421207. 350290619421210/355253229421215. 350290619421236/355253229421231. 350290619421251/355253229421256.
350290619421269/355253229421264. 350290619421293/355253229421298. 350290619421301/355253229421306. 350290619421319/35525322942131
4. 350290619421327/355253229421322. 350290619421335/355253229421330. 350290619421343/355253229421348. 350290619421350/35525322942
1355. 350290619421376/355253229421371. 350290619421384/355253229421389. 350290619421392/355253229421397. 350290619421400/35525322
9421405. 350290619421418/355253229421413. 350290619421442/355253229421447. 350290619421459/355253229421454. 350290619421475/35525
3229421470. 350290619421491/355253229421496. 350290619421525/355253229421520. 350290619422507/355253229422502. 350290619422515/35
5253229422510. 350290619422531/355253229422536. 350290619422549/355253229422544. 350290619422556/355253229422551. 350290619422572
/355253229422577. 350290619422580/355253229422585. 350290619422598/355253229422593. 350290619422606/355253229422601. 350290619422
614/355253229422619. 350290619422622/355253229422627. 350290619422648/355253229422643. 350290619422655/355253229422650. 350290619
422663/355253229422668. 350290619422671/355253229422676. 350290619422689/355253229422684. 350290619422705/355253229422700. 350290
619422713/355253229422718. 350290619422721/355253229422726. 350290619422747/355253229422742. 350290619422754/355253229422759. 350
290619422762/355253229422767. 350290619422770/355253229422775. 350290619422796/355253229422791.350290619422820/355253229422825. 3
50290619422853/355253229422858. 350290619422861/355253229422866. 350290619422911/355253229422916. 350290619422960/355253229422965
. 350290619422978/355253229422973. 350290619422994/355253229422999. 350290619423000/355253229423005. 350290619423018/355253229423
013. 350290619423042/355253229423047. 350290619423059/355253229423054. 350290619423075/355253229423070. 350290619423109/355253229
423104. 350290619423117/355253229423112. 350290619423133/355253229423138. 350290619423141/355253229423146. 350290619423158/355253
229423153.350290619423166/355253229423161. 350290619423174/355253229423179. 350290619423182/355253229423187. 350290619423208/3552
53229423203. 350290619423216/355253229423211. 350290619423224/355253229423229. 350290619423232/355253229423237. 350290619423257/3
55253229423252. 350290619423265/355253229423260. 350290619423299/355253229423294. 350290619423315/355253229423310. 35029061942333
1/355253229423336. 350290619423349/355253229423344. 350290619423364/355253229423369. 350290619423372/355253229423377. 35029061942
3380/355253229423385. 350290619423406/355253229423401. 350290619423422/355253229423427. 350290619423430/355253229423435. 35029061
032025000023666-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000023666-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
9423448/355253229423443. 350290619425724/355253229425729. 350290619425732/355253229425737. 350290619428504/355253229428509. 35029
0619428652/355253229428657. 350290619428686/355253229428681. 350290619428744/355253229428749. 350290619428819/355253229428814. 35
0290619428983/355253229428988. 350290619429312/355253229429317. 350290619433751/355253229433756XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025000023666-3
Espacio para uso exclusivo de la Entidad Recaudadora
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