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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
032025000806173-5
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. 116575015467031
43 . Año – Mes – Día
2025 – 04 – 13
44 . Documento de transporte
No. HKG0404132
45 . Año – Mes – Día
2025 – 04 – 07
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
6900354083
52 . Año – Mes – Día
2025 – 04 – 01
53 . Cod. país
procedencia
351
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
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.
140.00
72 . Peso neto kgs. dcms.
111.11
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
410.00
78 .Valor FOB
USD
26.430.21
79 . Valor fletes USD
1.106.00 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
113.730.316
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
113.730.316
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
1.33
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.107.33
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
27.537.54
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: 553995-DECL: 1904990-DO: 893108783251- 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: 3086982217. ID DELIVERY: 6081415221. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZSGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, MO(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
032025000806173
133. Feha: 202504 11
134 . Levante No. 032025000540009 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 92032502875471
Fecha presentación 2025-04-11 19:57:55
Valor pagado $0.00
Fecha de Impresión: 2025-04-14 14:48:22
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000806173-5
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DELO: SM-A055M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,SILVER,LTC( QTY. 410,00 u )(410,00 PCE);
IMEIS: 351641246000935/351847826000936. 351641246000950/351847826000951. 351641246000968/351847826000969. 351641246000992/351847
826000993. 351641246001008/351847826001009. 351641246001016/351847826001017. 351641246001024/351847826001025. 351641246001032/351
847826001033. 351641246001040/351847826001041. 351641246001073/351847826001074. 351641246001081/351847826001082. 351641246001099/
351847826001090. 351641246001107/351847826001108. 351641246001115/351847826001116. 351641246001131/351847826001132. 3516412460011
49/351847826001140. 351641246001156/351847826001157. 351641246001164/351847826001165. 351641246001172/351847826001173. 3516412460
01180/351847826001181. 351641246001206/351847826001207. 351641246001222/351847826001223. 351641246001230/351847826001231. 3516412
46001255/351847826001256. 351641246001263/351847826001264. 351641246001271/351847826001272. 3 51641246001289/351847826001280. 351
641246001297/351847826001298. 351641246001305/351847826001306. 351641246001313/351847826001314. 351641246001321/351847826001322.
351641246001339/351847826001330. 351641246001347/351847826001348. 351641246001354/351847826001355. 351641246001362/35184782600136
3. 351641246001370/351847826001371. 351641246001388/351847826001389. 351641246001396/351847826001397. 351641246001404/35184782600
1405. 351641246001412/351847826001413. 351641246001420/351847826001421. 351641246001438/351847826001439. 351641246001446/35184782
6001447.351641246001453/351847826001454. 351641246001461/351847826001462. 351641245989625/351847825989626. 351641245989633/351847
825989634. 351641245989641/351847825989642. 351641245989666/351847825989667. 351641245989674/351847825989675. 351641245989682/351
847825989683. 351641245989690/351847825989691. 351641245989708/351847825989709. 351641245989716/351847825989717. 351641245989724/
351847825989725. 351641245989732/351847825989733. 351641245989740/351847825989741. 351641245989757/351847825989758. 3516412459897
65/351847825989766. 351641245989773/351847825989774.351641245989781/351847825989782. 351641245989799/351847825989790. 35164124598
9807/351847825989808. 351641245989823/351847825989824. 351641245989849/351847825989840. 351641245989856/351847825989857. 35164124
5989864/351847825989865. 351641245989872/351847825989873. 351641245989880/351847825989881. 351641245989922/351847825989923. 35164
1245989930/351847825989931. 351641245989948/351847825989949. 351641245990102/351847825990103. 351641245990144/351847825990145. 35
1641245990151/351847825990152. 351641245990169/351847825990160. 351641245990177/351847825990178. 351641245990185/351847825990186.
351641245990193/351847825990194. 351641245990201/351847825990202. 351641245990219/351847825990210. 351641245990227/3518478259902
28. 351641245990235/351847825990236. 351641245990243/351847825990244. 351641245990276/351847825990277. 351641245990292/3518478259
90293. 351641245990300/351847825990301. 351641245990326/351847825990327. 351641245990342/351847825990343. 351641245990359/3518478
25990350. 351641245988163/351847825988164. 351641245988189/351847825988180. 351641245988197/351847825988198. 351641245988213/3518
47825988214. 351641245988221/351847825988222. 351641245988262/351847825988263. 351641245988312/351847825988313. 351641245988320/3
51847825988321. 351641245988353/351847825988354. 351641245988379/351847825988370. 351641245988387/351847825988388. 35164124598840
3/351847825988404. 351641245988411/351847825988412. 351641245988445/351847825988446. 351641245988460/351847825988461. 35164124598
8494/351847825988495. 351641245988510/351847825988511. 351641245988569/351847825988560. 351641245988601/351847825988602. 35164124
5988668/351847825988669. 351641245988676/351847825988677. 351641245988692/351847825988693. 351641245988700/351847825988701.351641
245988718/351847825988719. 351641245988734/351847825988735. 351641245988742/351847825988743. 351641245988759/351847825988750. 351
641245988809/351847825988800. 351641245988858/351847825988859. 351641245988866/351847825988867. 351641245988882/351847825988883.
351641245988908/351847825988909. 351641245988916/351847825988917. 351641245988965/351847825988966. 351641245989013/35184782598901
4. 351641245989021/351847825989022. 351641245989039/351847825989030. 351641245989047/351847825989048. 351641245989054/35184782598
9055. 351641245989062/351847825989063.351641245989070/351847825989071. 351641245989088/351847825989089. 351641245989096/351847825
989097. 351641245989104/351847825989105. 351641245989112/351847825989113. 351641245989120/351847825989121. 351641245989138/351847
825989139. 351641245989146/351847825989147. 351641245989153/351847825989154. 351641245989179/351847825989170. 351641245989187/351
847825989188. 351641245989195/351847825989196. 351641245989203/351847825989204. 351641245989211/351847825989212. 351641245989229/
351847825989220. 351641245989237/351847825989238. 351641245989245/351847825989246. 351641245989252/351847825989253. 3516412459892
60/351847825989261. 351641245989278/351847825989279. 351641245989286/351847825989287. 351641245989294/351847825989295. 3516412459
89302/351847825989303. 351641245989310/351847825989311. 351641245989328/351847825989329. 351641245989336/351847825989337. 3516412
45989344/351847825989345. 351641245989351/351847825989352. 351641245989369/351847825989360. 351641245989377/351847825989378. 3516
41245989385/351847825989386. 351641245989393/351847825989394. 351641245989401/351847825989402. 351641245989419/351847825989410. 3
51641245989427/351847825989428. 351641245989435/351847825989436. 351641245989443/351847825989444. 351641245989450/351847825989451
. 351641245989468/351847825989469. 351641245989476/351847825989477. 351641245989484/351847825989485. 351641245989500/351847825989
501. 351641245989518/351847825989519. 351641245989526/351847825989527. 351641245989534/351847825989535. 351641245989542/351847825
989543. 351641245989559/351847825989550. 351641245989567/351847825989568. 351641245989609/351847825989600. 351641245989617/351847
825989618. 351641245991068/351847825991069. 351641245991076/351847825991077. 351641245991084/351847825991085.351641245991092/3518
47825991093. 351641245991100/351847825991101. 351641245991118/351847825991119. 351641245991126/351847825991127. 351641245991134/3
51847825991135. 351641245991142/351847825991143. 351641245991183/351847825991184. 351641245991365/351847825991366. 35164124599145
6/351847825991457. 351641245991597/351847825991598. 351641245991746/351847825991747. 351641245991837/351847825991838. 35164124599
1878/351847825991879. 351641245991944/351847825991945. 351641245991977/351847825991978. 351641245992249/351847825992240. 35164124
5992454/351847825992455.351641245992686/351847825992687. 351641245993262/351847825993263. 351641245993361/351847825993362. 351641
245993379/351847825993370. 351641245993924/351847825993925. 351641245993957/351847825993958. 351641245993965/351847825993966. 351
641245993973/351847825993974. 351641245994013/351847825994014. 351641245994138/351847825994139. 351641245994211/351847825994212.
351641245994419/351847825994410. 351641245994609/351847825994600. 351641245994633/351847825994634. 351641245994641/35184782599464
2. 351641245994658/351847825994659. 351641245994682/351847825994683. 351641245994690/351847825994691. 351641245994716/35184782599
4717. 351641245994724/351847825994725. 351641245994732/351847825994733. 351641245994757/351847825994758. 351641245994781/35184782
5994782. 351641245994815/351847825994816. 351641245994823/351847825994824. 351641245994831/351847825994832. 351641245994849/35184
7825994840. 351641245994856/351847825994857. 351641245994880/351847825994881. 351641245994914/351847825994915. 351641245994955/35
1847825994956. 351641245995093/351847825995094. 351641245995457/351847825995458. 351641245995515/351847825995516. 351641245995549
/351847825995540. 351641245995580/351847825995581. 351641245995598/351847825995599. 351641245995606/351847825995607. 351641245995
630/351847825995631. 351641245995648/351847825995649. 351641245995663/351847825995664. 351641245995689/351847825995680. 351641245
995697/351847825995698. 351641245995713/351847825995714. 351641245995739/351847825995730. 351641245995747/351847825995748. 351641
245995770/351847825995771. 351641245995796/351847825995797. 351641245995804/351847825995805. 351641245995812/351847825995813. 351
641245995838/351847825995839. 351641245995861/351847825995862. 351641245995879/351847825995870.351641245995887/351847825995888. 3
51641245995911/351847825995912. 351641245995937/351847825995938. 351641245996042/351847825996043. 351641245996059/351847825996050
. 351641245996083/351847825996084. 351641245996158/351847825996159. 351641245996265/351847825996266. 351641245996364/351847825996
365. 351641245996604/351847825996605. 351641245996646/351847825996647. 351641245996687/351847825996688. 351641245996752/351847825
996753. 351641245996786/351847825996787. 351641245996810/351847825996811. 351641245996869/351847825996860. 351641245996935/351847
825996936.351641245996943/351847825996944. 351641245996976/351847825996977. 351641245996984/351847825996985. 351641245997099/3518
47825997090. 351641245997149/351847825997140. 351641245997180/351847825997181. 351641245997198/351847825997199. 351641245997214/3
51847825997215. 351641245997222/351847825997223. 351641245997255/351847825997256. 351641245997271/351847825997272. 35164124599808
9/351847825998080. 351641245998220/351847825998221. 351641245998782/351847825998783. 351641245998881/351847825998882. 35164124599
9269/351847825999260. 351641245999343/351847825999344. 351641245999376/351847825999377. 351641245999384/351847825999385. 35164124
032025000806173-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000806173-5
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
5999426/351847825999427. 351641245999442/351847825999443. 351641245999475/351847825999476. 351641245999582/351847825999583. 35164
1245999699/351847825999690. 351641245999707/351847825999708. 351641245999749/351847825999740. 351641245999848/351847825999849. 35
1641246000075/351847826000076. 351641246000299/351847826000290. 351641246000307/351847826000308. 351641246000406/351847826000407.
351641246000430/351847826000431. 351641246000513/351847826000514. 351641246000604/351847826000605. 351641246000638/3518478260006
39. 351641246000695/351847826000696. 351641246000703/351847826000704. 351641246000711/351847826000712. 351641246000729/3518478260
00720. 351641246000745/351847826000746. 351641246000794/351847826000795. 351641246000828/351847826000829. 351641246000869/3518478
26000860. 351641246000919/351847826000910. 351641246000927/351847826000928. 351641245990367/351847825990368. 351641245990409/3518
47825990400. 351641245990417/351847825990418. 351641245990458/351847825990459. 351641245990524/351847825990525. 351641245990540/3
51847825990541. 351641245990557/351847825990558. 351641245990573/351847825990574.351641245990581/351847825990582. 351641245990599
/351847825990590. 351641245990607/351847825990608. 351641245990631/351847825990632. 351641245990656/351847825990657. 351641245990
672/351847825990673. 351641245990680/351847825990681. 351641245990698/351847825990699. 351641245990706/351847825990707. 351641245
990714/351847825990715. 351641245990722/351847825990723. 351641245990730/351847825990731. 351641245990748/351847825990749. 351641
245990755/351847825990756. 351641245990763/351847825990764. 351641245990771/351847825990772. 351641245990789/351847825990780.3516
41245990813/351847825990814. 351641245990821/351847825990822. 351641245990839/351847825990830. 351641245990847/351847825990848. 3
51641245990854/351847825990855. 351641245990862/351847825990863. 351641245990870/351847825990871. 351641245990888/351847825990889
. 351641245990904/351847825990905. 351641245990920/351847825990921. 351641245990938/351847825990939. 351641245990946/351847825990
947. 351641245990953/351847825990954. 351641245990961/351847825990962. 351641245990979/351847825990970. 351641245990987/351847825
990988. 351641245990995/351847825990996. 351641245991019/351847825991010. 351641245991027/351847825991028. 351641245991043/351847
825991044. 351641246001479/351847826001470. 351641246001487/351847826001488. 351641246001503/351847826001504. 351641246001511/351
847826001512. 351641246001529/351847826001520. 351641246001537/351847826001538. 351641246001545/351847826001546. 351641246001552/
351847826001553. 351641246001560/351847826001561. 351641246001578/351847826001579. 351641246001586/351847826001587. 3516412460015
94/351847826001595. 351641246001602/351847826001603. 351641246001610/351847826001611. 351641246001628/351847826001629. 3516412460
01636/351847826001637. 351641246001644/351847826001645. 351641246001651/351847826001652. 351641246001669/351847826001660. 3516412
46001677/351847826001678. 351641246001685/351847826001686. 351641246001693/351847826001694. 351641246001768/351847826001769. 3516
41246001776/351847826001777. 351641246001784/351847826001785. 351641246001818/351847826001819. 351641246001826/351847826001827. 3
51641246001834/351847826001835. 351641246001859/351847826001850. 351641246001867/351847826001868. 351641246001875/351847826001876
. 351641246001883/351847826001884. 351641246001909/351847826001900.351641246001917/351847826001918. 351641246001933/3518478260019
34. 351641246001941/351847826001942. 351641246001958/351847826001959. 351641246001966/351847826001967. 351641246001982/3518478260
01983. 351641246001990/351847826001991. 351641246002055/351847826002056. 351641246002097/351847826002098. 351641246002113/3518478
26002114. 351641246002121/351847826002122. 351641246002139/351847826002130. 351641246002154/351847826002155. 351641246002162/3518
47826002163. 351641246002170/351847826002171. 351641246002188/351847826002189. 351641246002238/351847826002239XXXXXXXXXXXXXXXXXXX
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032025000806173-5
Espacio para uso exclusivo de la Entidad Recaudadora
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