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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
0320250000278059
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. 116575015133898
43 . Año Mes
Día
2025 01
02
44 . Documento de transporte
No. SZX7975486
45 . Año Mes
Día
2024 12
23
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
21789
52 . Año Mes
Día
2025 01
02
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.
4.410.50
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
03
69 . Tipo de
importación
01
70 . Cod. país
compra
249
71 . Peso bruto kgs. dcms.
500.15
72 . Peso neto kgs. dcms.
450.14
73 . Código
embalaje
PK
74 . No. bultos
5
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
1.000.00
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 202532097 CODIGO / RESOLUCION OEA IMPORTADOR: OE0169; DECLARACION(25)
NOS ACOGEMOS AL ART 424 DEL ESTATUTO TRIBUTARIO MODIFIC
ADO POR LEY 1819 DE 29 DE DICIEMBRE 2016, NUEVA REFORMA TRIBUTARIA, ART 175 PARA COMPUTADORESPORTATILES, DE ESCRITORIOTABLETAS Y
CELULARES. // DOCUMENTO DE VERIFICACION DE IMEI: DV222034,
FECHA: 20250108..
FACTURA: 21789 FECHA: 20250102
NOS ACOGEMOS AL
DECRETO 1881 DEL 2021, NOS ACOGEMOS AL DECRETO 0925 DE MAYO 9 DEL 2013, MINISTERIO DE COMERCIO EXTERIOR, IMPORTACIÓN EXENTA DE R
EGISTRO DE IMPORTACIÓN.. CANT (1000) UND HOMOLOGACIÓN DEL EQUIPO MARCA: REDMI, MODELO: 2409BRN2CL, RADICACION: 2024523502, FECH
A: 20240729.
// TELEFONO CELULAR, 1064245 REDMI 14C SAGE GREEN 4GB RAM 128GB ROM // ESPECIFICACIONES: PRO(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
032025000027805
133. Feha: 2025 01 09
134 . Levante No. 032025000025576 135 . Fecha
2025 01
09
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 92032500165446
Fecha presentación 20250109
07:37:06
Valor pagado $0.00
Fecha de Impresión: 20250109
07:42:59
Kelly Johanna Gonzalez Acero
C.C 1.023.862.658
REPÚBLICA DE COLOMBIA
Declaración
de
Importación
Aceptación :
0320250000278059
Subpartida :
8517130000
Página 1 de 6
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
CESADOR: MEDIATEK HELIO G81 ULTRA, PANTALLA: 6.88 PULGADAS (17.47 CM), MEMORIA: 4GB, ALMACENAMIENTO: 128GB, SISTEMA OPERATIVO: HY
PEROS. CONTIENE: TELEFONO CELULAR, ADAPTADOR DE CORRIENTE, CABLE USB TIPOC,
LLAVE PARA SIM CARD, CARCASA PROTECTORA, GUIA DE INI
CIO RAPIDO, TARJETA DE GARANTIA. // EAN: 6941812766491, ALIMENTACION: 5V3A/
3.611V3A
(33 W MAX), PRODUCTO TERMOSELLADO.// COD:
1064245. PRODUCTO: TELEFONO CELULAR, MARCA: REDMI/MI, MODELO: 2409BRN2CL, REFERENCIA: 59144/MZB0HX9US, USO O DESTINO: COMUNICACIÃ
“N, PARA ALMACENAMIENTO Y PROCESAMIENTO DE DATOS., SERIAL // IMEI NO. (CODIGO DE QUINCE 15DIGITOS):
59144/64YJ00315//869807074
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0320250000278059
Espacio para uso exclusivo de la Entidad
Recaudadora
REPÚBLICA DE COLOMBIA
Declaración
de
Importación
Aceptación :
0320250000278059
Subpartida :
8517130000
Página 2 de 6
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
464//869807074396472, 59144/64YJ01015//869807074396563//869807074396571, 59144/64YJ01044//869807074366020//869807074366038, 59144
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0320250000278059
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Página 3 de 6
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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461//869807074406479, 59144/64YJ03913//869807074406503//869807074406511, 59144/64YJ03914//869807074406529//869807074406537, 59144
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0320250000278059
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0320250000278059
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Página 6 de 6
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
807074383785//869807074383793, 59144/64YJ04252//869807074383801//869807074383819, 59144/64YJ04257//869807074383900//8698070743839
18, 59144/64YJ04258//869807074383926//869807074383934, 59144/64YJ04259//869807074337328//869807074337336, 59144/64YJ04260//869807
074337344//869807074337351, 59144/64YJ04262//869807074337385//869807074337393, 59144/64YJ04263//869807074337401//869807074337419,
59144/64YJ04264//869807074337427//869807074337435, 59144/64YJ04265//869807074337443//869807074337450, 59144/64YJ04266//869807074
352525//869807074352533, 59144/64YJ04267//869807074352541//869807074352558, 59144/64YJ04268//869807074352566//869807074352574, 59
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624//869807074352632, 59144/64YJ04272//869807074352640//869807074352657, 59144/64YJ04274//869807074352681//869807074352699, 59144
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//869807074352756, 59144/64YJ04278//869807074352764//869807074352772, 59144/64YJ04279//869807074352780//869807074352798, 59144/64
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4285//869807074352905//869807074352913, 59144/64YJ04286//869807074352921//869807074352939, 59144/64YJ04288//869807074352962//8698
07074352970, 59144/64YJ04291//869807074353028//869807074353036, 59144/64YJ04293//869807074353069//869807074353077, 59144/64YJ0429
6//869807074353127//869807074353135, 59144/64YJ04298//869807074353168//869807074353176, 59144/64YJ04299//869807074353184//8698070
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869807074386929//869807074386937, 59144/64YJ04377//869807074324201//869807074324219, 59144/64YJ04382//869807074324300//8698070743
24318, 59144/64YJ04385//869807074325265//869807074325273, 59144/64YJ04389//869807074325349//869807074325356, 59144/64YJ04393//869
807074325422//869807074325430, 59144/64YJ04395//869807074325463//869807074325471, 59144/64YJ04398//869807074325521//8698070743255
39, 59144/64YJ04399//869807074325547//869807074325554, 59144/64YJ04403//869807074325620//869807074325638, 59144/64YJ04405//869807
074325661//869807074325679, 59144/64YJ04407//869807074325703//869807074325711, 59144/64YJ04408//869807074325729//869807074325737,
59144/64YJ04410//869807074325760//869807074325778, 59144/64YJ04412//869807074325802//869807074325810, 59144/64YJ04419//869807074
325943//869807074325950, 59144/64YJ04420//869807074340488//869807074340496, 59144/64YJ04421//869807074340504//869807074340512, 59
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//869807074326750, PAIS ORIGEN: CHINA 215.
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0320250000278059
Espacio para uso exclusivo de la Entidad
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