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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
032025000798170-8
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
1022943854
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. 116575015460666
43 . Año – Mes – Día
2025 – 04 – 11
44 . Documento de transporte
No. 45T0378972
45 . Año – Mes – Día
2025 – 04 – 05
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
9103383854
52 . Año – Mes – Día
2025 – 04 – 04
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
244
56 . Cod. Depto
destino
0
57 . Empresa transportadora
EMIRATES SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.130.01
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
855
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.
123.00
72 . Peso neto kgs. dcms.
76.00
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
65.859.21
79 . Valor fletes USD
1.161.12 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
276.808.014
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
276.808.014
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
3.24
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.164.36
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
67.023.57
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: 553787-DECL: 1904319-DO: 893108484251- 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: 3087062902. ID DELIVERY:
6081338478. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A266MLGHLTC, PRODUCTO: TELEFONO CELULAR GALAXY A26 5G DUOS(CON ACCESORIOS PA
RA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE CLARO, MODELO: SM-A266M/DS, USO O DESTINO: PARA LA VENTA AL 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
032025000798170
133. Feha: 202504 10
134 . Levante No. 032025000539450 135 . Fecha
2025 – 04 – 14
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 92032502832595
Fecha presentación 2025-04-10 19:01:00
Valor pagado $0.00
Fecha de Impresión: 2025-04-14 14:09:31
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000798170-8
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
AYOR Y AL DETAL./ /MOBILE,SM-A266M/DS,LIGHT GREEN,LTC( QTY. 400,00 u )(400,00 PCE);IMEIS: 351813971333951/352975131333954. 351813
971334041/352975131334044. 351813971334108/352975131334101. 351813971334124/352975131334127. 351813971334215/352975131334218. 351
813971334231/352975131334234. 351813971334256/352975131334259. 351813971334272/352975131334275. 351813971334314/352975131334317.
351813971334330/352975131334333. 351813971334355/352975131334358. 351813971334389/352975131334382. 351813971334462/35297513133446
5. 351813971334488/352975131334481. 351813971334504/352975131334507. 351813971334538/352975131334531. 351813971334553/35297513133
4556. 351813971334561/352975131334564. 351813971334579/352975131334572. 351813971334694/352975131334697. 351813971334702/35297513
1334705.351813971334710/352975131334713. 351813971334744/352975131334747. 351813971334801/352975131334804. 351813971335022/352975
131335025. 351813971335048/352975131335041. 351813971335055/352975131335058. 351813971335 089/352975131335082. 351813971335097/35
2975131335090. 351813971335147/352975131335140. 351813971335212/352975131335215. 351813971335246/352975131335249. 351813971335279
/352975131335272. 351813971335303/352975131335306. 351813971335352/352975131335355. 351813971335360/352975131335363. 351813971335
394/352975131335397. 351813971335436/352975131335439.351813971335451/352975131335454. 351813971335519/352975131335512. 3518139713
35550/352975131335553. 351813971335568/352975131335561. 351813971335576/352975131335579. 351813971335584/352975131335587. 3518139
71335600/352975131335603. 351813971335618/352975131335611. 351813971335642/352975131335645. 351813971335667/352975131335660. 3518
13971335675/352975131335678. 351813971335733/352975131335736. 351813971335790/352975131335793. 351813971335808/352975131335801. 3
51813971335816/352975131335819. 351813971335824/352975131335827. 351813971335857/352975131335850. 351813971335881/352975131335884
. 351813971335907/352975131335900. 351813971335923/352975131335926. 351813971335931/352975131335934. 351813971335949/352975131335
942. 351813971335964/352975131335967. 351813971335972/352975131335975. 351813971335998/352975131335991. 351813971336012/352975131
336015. 351813971336087/352975131336080. 351813971336095/352975131336098. 351813971336129/352975131336122. 351813971336160/352975
131336163. 351813971336251/352975131336254. 351813971336269/352975131336262. 351813971336293/352975131336296. 351813971336335/352
975131336338. 351813971336343/352975131336346. 351813971336350/352975131336353. 351813971336525/352975131336528. 351813971336624/
352975131336627. 351813971336707/352975131336700. 351813971336723/352975131336726. 351813971336731/352975131336734. 3518139713367
56/352975131336759. 351813971336780/352975131336783. 351813971336806/352975131336809. 351813971336822/352975131336825. 3518139713
36830/352975131336833. 351813971336848/352975131336841. 351813971336855/352975131336858. 351813971336939/352975131336932. 3518139
71336996/352975131336999. 351813971337036/352975131337039. 351813971337077/352975131337070. 351813971337093/352975131337096.35181
3971337101/352975131337104. 351813971337119/352975131337112. 351813971337143/352975131337146. 351813971337168/352975131337161. 35
1813971337192/352975131337195. 351813971337267/352975131337260. 351813971337275/352975131337278. 351813971337390/352975131337393.
351813971337440/352975131337443. 351813971337457/352975131337450. 351813971337499/352975131337492. 351813971337523/3529751313375
26. 351813971337572/352975131337575. 351813971337598/352975131337591. 351813971337606/352975131337609. 351813971337614/3529751313
37617. 351813971337622/352975131337625.351813971337630/352975131337633. 351813971337655/352975131337658. 351813971337671/35297513
1337674. 351813971337689/352975131337682. 351813971337697/352975131337690. 351813971337713/352975131337716. 351813971337721/35297
5131337724. 351813971337754/352975131337757. 351813971337762/352975131337765. 351813971337796/352975131337799. 351813971337861/35
2975131337864. 351813971337879/352975131337872. 351813971337911/352975131337914. 351813971337945/352975131337948. 351813971338034
/352975131338037. 351813971338158/352975131338151. 351813971338174/352975131338177. 351813971338182/352975131338185. 351813971338
208/352975131338201. 351813971418281/352975131418284. 351813971418307/352975131418300. 351813971418315/352975131418318. 351813971
321881/352975131321884. 351813971321949/352975131321942. 351813971321956/352975131321959. 351813971322152/352975131322155. 351813
971322186/352975131322189. 351813971322194/352975131322197. 351813971322251/352975131322254. 351813971322277/352975131322270. 351
813971322285/352975131322288. 351813971322350/352975131322353. 351813971322376/352975131322379. 351813971322392/352975131322395.
351813971322418/352975131322411. 351813971322483/352975131322486. 351813971322525/352975131322528. 351813971322541/35297513132254
4. 351813971322566/352975131322569. 351813971322574/352975131322577. 351813971322657/352975131322650. 351813971322699/35297513132
2692. 351813971322806/352975131322809. 351813971322871/352975131322874. 351813971322913/352975131322916. 351813971322962/35297513
1322965. 351813971323051/352975131323054. 351813971323168/352975131323161. 351813971323176/352975131323179. 351813971323242/35297
5131323245. 351813971323267/352975131323260. 351813971323481/352975131323484. 351813971323499/352975131323492.351813971323614/352
975131323617. 351813971323663/352975131323666. 351813971324414/352975131324417. 351813971324430/352975131324433. 351813971324455/
352975131324458. 351813971324463/352975131324466. 351813971324539/352975131324532. 351813971324554/352975131324557. 3518139713246
04/352975131324607. 351813971324646/352975131324649. 351813971324653/352975131324656. 351813971324695/352975131324698. 3518139713
24729/352975131324722. 351813971324745/352975131324748. 351813971330486/352975131330489. 351813971330502/352975131330505. 3518139
71330569/352975131330562.351813971330684/352975131330687. 351813971330726/352975131330729. 351813971330742/352975131330745. 35181
3971330759/352975131330752. 351813971330783/352975131330786. 351813971330791/352975131330794. 351813971330809/352975131330802. 35
1813971330817/352975131330810. 351813971330841/352975131330844. 351813971331039/352975131331032. 351813971331054/352975131331057.
351813971331088/352975131331081. 351813971331112/352975131331115. 351813971331229/352975131331222. 351813971331286/3529751313312
89. 351813971331294/352975131331297. 351813971331328/352975131331321. 351813971331377/352975131331370. 351813971331393/3529751313
31396. 351813971331450/352975131331453. 351813971331492/352975131331495. 351813971331500/352975131331503. 351813971331518/3529751
31331511. 351813971331534/352975131331537. 351813971331542/352975131331545. 351813971331575/352975131331578. 351813971331583/3529
75131331586. 351813971331591/352975131331594. 351813971331617/352975131331610. 351813971331641/352975131331644. 351813971331666/3
52975131331669. 351813971331682/352975131331685. 351813971331690/352975131331693. 351813971331716/352975131331719. 35181397133172
4/352975131331727. 351813971331740/352975131331743. 351813971331773/352975131331776. 351813971331781/352975131331784. 35181397133
1799/352975131331792. 351813971331815/352975131331818. 351813971331823/352975131331826. 351813971331849/352975131331842. 35181397
1324752/352975131324755. 351813971324786/352975131324789. 351813971324802/352975131324805. 351813971324810/352975131324813. 35181
3971324828/352975131324821. 351813971324844/352975131324847. 351813971324851/352975131324854. 351813971325023/352975131325026. 35
1813971325148/352975131325141. 351813971325320/352975131325323. 351813971325452/352975131325455.351813971325619/352975131325612.
351813971325684/352975131325687. 351813971325759/352975131325752. 351813971325809/352975131325802. 351813971325833/35297513132583
6. 351813971325858/352975131325851. 351813971325866/352975131325869. 351813971325874/352975131325877. 351813971325916/35297513132
5919. 351813971325924/352975131325927. 351813971325940/352975131325943. 351813971325999/352975131325992. 351813971326005/35297513
1326008. 351813971326013/352975131326016. 351813971326021/352975131326024. 351813971326039/352975131326032. 351813971326047/35297
5131326040.351813971326054/352975131326057. 351813971326088/352975131326081. 351813971326096/352975131326099. 351813971326104/352
975131326107. 351813971326112/352975131326115. 351813971326138/352975131326131. 351813971326146/352975131326149. 351813971326385/
352975131326388. 351813971326435/352975131326438. 351813971326450/352975131326453. 351813971326468/352975131326461. 3518139713264
92/352975131326495. 351813971326518/352975131326511. 351813971326617/352975131326610. 351813971326625/352975131326628. 3518139713
26633/352975131326636. 351813971326658/352975131326651. 351813971326682/352975131326685. 351813971326690/352975131326693. 3518139
71326724/352975131326727. 351813971326732/352975131326735. 351813971326740/352975131326743. 351813971327169/352975131327162. 3518
13971327235/352975131327238. 351813971327276/352975131327279. 351813971327300/352975131327303. 351813971327326/352975131327329. 3
51813971327334/352975131327337. 351813971327342/352975131327345. 351813971327383/352975131327386. 351813971327391/352975131327394
. 351813971327425/352975131327428. 351813971327474/352975131327477. 351813971327656/352975131327659. 351813971327789/352975131327
782. 351813971328597/352975131328590. 351813971329165/352975131329168. 351813971329173/352975131329176. 351813971329181/352975131
329184. 351813971329207/352975131329200. 351813971329249/352975131329242. 351813971329272/352975131329275. 351813971329280/352975
032025000798170-8
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000798170-8
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
131329283. 351813971329363/352975131329366. 351813971329371/352975131329374. 351813971329462/352975131329465. 351813971329496/352
975131329499. 351813971329504/352975131329507. 351813971329595/352975131329598. 351813971329686/352975131329689. 351813971329819/
352975131329812. 351813971329967/352975131329960. 351813971330007/352975131330000.351813971330023/352975131330026. 35181397133007
2/352975131330075. 351813971330098/352975131330091. 351813971330106/352975131330109. 351813971330155/352975131330158. 35181397133
0213/352975131330216. 351813971330296/352975131330299. 351813971330346/352975131330349. 351813971330478/352975131330471. 35181397
1331856/352975131331859. 351813971331864/352975131331867. 351813971331922/352975131331925. 351813971331963/352975131331966. 35181
3971331997/352975131331990. 351813971332052/352975131332055. 351813971332169/352975131332162. 351813971332193/352975131332196.351
813971332201/352975131332204. 351813971332227/352975131332220. 351813971332235/352975131332238. 351813971332250/352975131332253.
351813971332276/352975131332279. 351813971332284/352975131332287. 351813971332292/352975131332295. 351813971332300/35297513133230
3. 351813971332334/352975131332337. 351813971332342/352975131332345. 351813971332359/352975131332352. 351813971332367/35297513133
2360. 351813971332375/352975131332378. 351813971332383/352975131332386. 351813971332409/352975131332402. 351813971332417/35297513
1332410. 351813971332433/352975131332436. 351813971332458/352975131332451. 351813971332524/352975131332527. 351813971332557/35297
5131332550. 351813971332581/352975131332584. 351813971332599/352975131332592. 351813971332623/352975131332626. 351813971332631/35
2975131332634. 351813971332649/352975131332642. 351813971332714/352975131332717. 351813971332862/352975131332865. 351813971332888
/352975131332881. 351813971332896/352975131332899. 351813971332912/352975131332915. 351813971332920/352975131332923. 351813971332
987/352975131332980. 351813971333001/352975131333004. 351813971333027/352975131333020. 351813971333050/352975131333053. 351813971
333076/352975131333079. 351813971333084/352975131333087. 351813971333118/352975131333111. 351813971333134/352975131333137. 351813
971333142/352975131333145. 351813971333159/352975131333152. 351813971333167/352975131333160. 351813971333175/352975131333178. 351
813971333191/352975131333194. 351813971333209/352975131333202. 351813971333217/352975131333210. 351813971333233/352975131333236.
351813971333241/352975131333244. 351813971333258/352975131333251. 351813971333274/352975131333277. 351813971333308/35297513133330
1. 351813971333332/352975131333335. 351813971333373/352975131333376.351813971333381/352975131333384. 351813971333399/352975131333
392. 351813971333431/352975131333434. 351813971333449/352975131333442. 351813971333472/352975131333475. 351813971333548/352975131
333541. 351813971333555/352975131333558. 351813971333589/352975131333582. 351813971333597/352975131333590. 351813971333621/352975
131333624. 351813971333639/352975131333632. 351813971333654/352975131333657. 351813971333688/352975131333681. 351813971333696/352
975131333699. 351813971333746/352975131333749. 351813971333753/352975131333756. 351813971333803/352975131333806.351813971333811/3
52975131333814. 351813971333829/352975131333822. 351813971333837/352975131333830. 351813971333852/352975131333855. 35181397133386
0/352975131333863. 351813971333886/352975131333889. 351813971333894/352975131333897. 351813971333902/352975131333905. 35181397133
3910/352975131333913. 351813971333928/352975131333921. 351813971333936/352975131333939. 351813971333944/352975131333947XXXXXXXXXX
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032025000798170-8
Espacio para uso exclusivo de la Entidad Recaudadora
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