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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
032025000839529-5
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
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. 116575015486618
43 . Año – Mes – Día
2025 – 04 – 20
44 . Documento de transporte
No. 41N0699791
45 . Año – Mes – Día
2025 – 04 – 15
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
6900357910
52 . Año – Mes – Día
2025 – 04 – 10
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.
4.329.90
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.
132.00
72 . Peso neto kgs. dcms.
102.98
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
380.00
78 .Valor FOB
USD
20.303.75
79 . Valor fletes USD
963.60 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
92.089.959
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
92.089.959
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
1.03
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
964.63
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
21.268.38
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: 554882-DECL: 1907371-DO: 893109621251- 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: 3087436374. ID DELIVERY: 6081551002. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZSDLTC, 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
032025000839529
133. Feha: 202504 21
134 . Levante No. 032025000597334 135 . Fecha
2025 – 04 – 21
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 92032503080868
Fecha presentación 2025-04-21 20:31:09
Valor pagado $0.00
Fecha de Impresión: 2025-04-21 20:31:16
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000839529-5
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. 380,00 u )(380,00 PCE);
IMEIS: 351641246196147/351847826196148. 351641246196154/351847826196155. 351641246196162/351847826196163. 351641246196170/351847
826196171. 351641246196188/351847826196189. 351641246196196/351847826196197. 351641246196204/351847826196205. 351641246196212/351
847826196213. 351641246196220/351847826196221. 351641246196238/351847826196239. 351641246196246/351847826196247. 351641246196253/
351847826196254. 351641246196261/351847826196262. 351641246196279/351847826196270. 351641246196287/351847826196288. 3516412461962
95/351847826196296. 351641246196303/351847826196304. 351641246196311/351847826196312. 351641246196329/351847826196320. 3516412461
96337/351847826196338. 351641246196345/351847826196346. 351641246196352/351847826196353. 351641246196360/351847826196361. 3516412
46196378/351847826196379. 351641246196386/351847826196387. 351641246196394/351847826196395. 3 51641246196402/351847826196403. 351
641246196410/351847826196411. 351641246196428/351847826196429. 351641246196436/351847826196437. 351641246196444/351847826196445.
351641246196451/351847826196452. 351641246196469/351847826196460. 351641246196477/351847826196478. 351641246196485/35184782619648
6. 351641246196493/351847826196494. 351641246196501/351847826196502. 351641246196519/351847826196510. 351641246196527/35184782619
6528. 351641246196535/351847826196536. 351641246196543/351847826196544. 351641246196550/351847826196551. 351641246196568/35184782
6196569.351641246196576/351847826196577. 351641246196584/351847826196585. 351641246197046/351847826197047. 351641246197053/351847
826197054. 351641246197061/351847826197062. 351641246197079/351847826197070. 351641246197087/351847826197088. 351641246197095/351
847826197096. 351641246197103/351847826197104. 351641246197111/351847826197112. 351641246197129/351847826197120. 351641246197137/
351847826197138. 351641246197145/351847826197146. 351641246197152/351847826197153. 351641246197160/351847826197161. 3516412461971
78/351847826197179. 351641246197186/351847826197187.351641246197194/351847826197195. 351641246197202/351847826197203. 35164124619
7210/351847826197211. 351641246197228/351847826197229. 351641246197236/351847826197237. 351641246197244/351847826197245. 35164124
6197251/351847826197252. 351641246197269/351847826197260. 351641246197277/351847826197278. 351641246197285/351847826197286. 35164
1246197293/351847826197294. 351641246197301/351847826197302. 351641246197319/351847826197310. 351641246197327/351847826197328. 35
1641246197335/351847826197336. 351641246197343/351847826197344. 351641246197350/351847826197351. 351641246197368/351847826197369.
351641246197376/351847826197377. 351641246197384/351847826197385. 351641246197392/351847826197393. 351641246197400/3518478261974
01. 351641246197418/351847826197419. 351641246197426/351847826197427. 351641246197434/351847826197435. 351641246197442/3518478261
97443. 351641246197459/351847826197450. 351641246197467/351847826197468. 351641246197475/351847826197476. 351641246197483/3518478
26197484. 351641246196592/351847826196593. 351641246196600/351847826196601. 351641246196618/351847826196619. 351641246196626/3518
47826196627. 351641246196634/351847826196635. 351641246196642/351847826196643. 351641246196659/351847826196650. 351641246196667/3
51847826196668. 351641246196675/351847826196676. 351641246196683/351847826196684. 351641246196691/351847826196692. 35164124619670
9/351847826196700. 351641246196717/351847826196718. 351641246196725/351847826196726. 351641246196733/351847826196734. 35164124619
6741/351847826196742. 351641246196758/351847826196759. 351641246196766/351847826196767. 351641246196774/351847826196775. 35164124
6196782/351847826196783. 351641246196790/351847826196791. 351641246196808/351847826196809. 351641246196816/351847826196817.351641
246196824/351847826196825. 351641246196832/351847826196833. 351641246196840/351847826196841. 351641246196857/351847826196858. 351
641246196865/351847826196866. 351641246196873/351847826196874. 351641246196881/351847826196882. 351641246196899/351847826196890.
351641246196907/351847826196908. 351641246196915/351847826196916. 351641246196923/351847826196924. 351641246196931/35184782619693
2. 351641246196949/351847826196940. 351641246196956/351847826196957. 351641246196964/351847826196965. 351641246196972/35184782619
6973. 351641246196980/351847826196981.351641246196998/351847826196999. 351641246197004/351847826197005. 351641246197012/351847826
197013. 351641246197020/351847826197021. 351641246197038/351847826197039. 351641246195693/351847826195694. 351641246195701/351847
826195702. 351641246195719/351847826195710. 351641246195727/351847826195728. 351641246195735/351847826195736. 351641246195743/351
847826195744. 351641246195750/351847826195751. 351641246195768/351847826195769. 351641246195776/351847826195777. 351641246195784/
351847826195785. 351641246195792/351847826195793. 351641246195800/351847826195801. 351641246195818/351847826195819. 3516412461958
26/351847826195827. 351641246195834/351847826195835. 351641246195842/351847826195843. 351641246195859/351847826195850. 3516412461
95867/351847826195868. 351641246195875/351847826195876. 351641246195883/351847826195884. 351641246195891/351847826195892. 3516412
46195909/351847826195900. 351641246195917/351847826195918. 351641246195925/351847826195926. 351641246195933/351847826195934. 3516
41246195941/351847826195942. 351641246195958/351847826195959. 351641246195966/351847826195967. 351641246195974/351847826195975. 3
51641246195982/351847826195983. 351641246195990/351847826195991. 351641246196006/351847826196007. 351641246196014/351847826196015
. 351641246196022/351847826196023. 351641246196030/351847826196031. 351641246196048/351847826196049. 351641246196055/351847826196
056. 351641246196063/351847826196064. 351641246196071/351847826196072. 351641246196089/351847826196080. 351641246196097/351847826
196098. 351641246196105/351847826196106. 351641246196113/351847826196114. 351641246196121/351847826196122. 351641246196139/351847
826196130. 351641246197491/351847826197492. 351641246197509/351847826197500. 351641246197517/351847826197518.351641246197525/3518
47826197526. 351641246197533/351847826197534. 351641246197541/351847826197542. 351641246197558/351847826197559. 351641246197566/3
51847826197567. 351641246197574/351847826197575. 351641246197582/351847826197583. 351641246197590/351847826197591. 35164124619760
8/351847826197609. 351641246197616/351847826197617. 351641246197624/351847826197625. 351641246197632/351847826197633. 35164124619
7640/351847826197641. 351641246197657/351847826197658. 351641246197665/351847826197666. 351641246197673/351847826197674. 35164124
6197681/351847826197682.351641246197699/351847826197690. 351641246197707/351847826197708. 351641246197715/351847826197716. 351641
246197723/351847826197724. 351641246197731/351847826197732. 351641246197749/351847826197740. 351641246197756/351847826197757. 351
641246197764/351847826197765. 351641246197772/351847826197773. 351641246197780/351847826197781. 351641246197798/351847826197799.
351641246197806/351847826197807. 351641246197814/351847826197815. 351641246197822/351847826197823. 351641246197830/35184782619783
1. 351641246197848/351847826197849. 351641246197855/351847826197856. 351641246197863/351847826197864. 351641246197871/35184782619
7872. 351641246197889/351847826197880. 351641246197897/351847826197898. 351641246197905/351847826197906. 351641246197913/35184782
6197914. 351641246197921/351847826197922. 351641246197939/351847826197930. 351641246197947/351847826197948. 351641246197954/35184
7826197955. 351641246197962/351847826197963. 351641246197970/351847826197971. 351641246197988/351847826197989. 351641246197996/35
1847826197997. 351641246198002/351847826198003. 351641246198010/351847826198011. 351641246198028/351847826198029. 351641246198036
/351847826198037. 351641246198044/351847826198045. 351641246198051/351847826198052. 351641246198069/351847826198060. 351641246198
077/351847826198078. 351641246198085/351847826198086. 351641246198093/351847826198094. 351641246198101/351847826198102. 351641246
198119/351847826198110. 351641246198127/351847826198128. 351641246198135/351847826198136. 351641246198143/351847826198144. 351641
246198150/351847826198151. 351641246198168/351847826198169. 351641246198176/351847826198177. 351641246198184/351847826198185. 351
641246198192/351847826198193. 351641246198200/351847826198201. 351641246198218/351847826198219.351641246198226/351847826198227. 3
51641246198234/351847826198235. 351641246198242/351847826198243. 351641246198259/351847826198250. 351641246198267/351847826198268
. 351641246198275/351847826198276. 351641246198283/351847826198284. 351641246198291/351847826198292. 351641246198309/351847826198
300. 351641246198317/351847826198318. 351641246198325/351847826198326. 351641246198333/351847826198334. 351641246198341/351847826
198342. 351641246198358/351847826198359. 351641246198366/351847826198367. 351641246198374/351847826198375. 351641246198382/351847
826198383.351641246198390/351847826198391. 351641246198408/351847826198409. 351641246198416/351847826198417. 351641246198424/3518
47826198425. 351641246198432/351847826198433. 351641246198440/351847826198441. 351641246198457/351847826198458. 351641246198465/3
51847826198466. 351641246198473/351847826198474. 351641246198481/351847826198482. 351641246198499/351847826198490. 35164124619850
7/351847826198508. 351641246198515/351847826198516. 351641246198523/351847826198524. 351641246198531/351847826198532. 35164124619
8549/351847826198540. 351641246198556/351847826198557. 351641246198564/351847826198565. 351641246198572/351847826198573. 35164124
032025000839529-5
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025000839529-5
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
6198580/351847826198581. 351641246198598/351847826198599. 351641246198606/351847826198607. 351641246198614/351847826198615. 35164
1246198622/351847826198623. 351641246198630/351847826198631. 351641246198648/351847826198649. 351641246198655/351847826198656. 35
1641246198663/351847826198664. 351641246198671/351847826198672. 351641246198689/351847826198680. 351641246198697/351847826198698.
351641246198705/351847826198706. 351641246198713/351847826198714. 351641246198721/351847826198722. 351641246198739/3518478261987
30. 351641246198747/351847826198748. 351641246198754/351847826198755. 351641246198762/351847826198763. 351641246198770/3518478261
98771. 351641246198788/351847826198789. 351641246198796/351847826198797. 351641246198804/351847826198805. 351641246198812/3518478
26198813. 351641246198820/351847826198821. 351641246198838/351847826198839. 351641246198846/351847826198847. 351641246198853/3518
47826198854. 351641246198861/351847826198862. 351641246198879/351847826198870. 351641246198887/351847826198888. 351641246198895/3
51847826198896. 351641246198903/351847826198904. 351641246198911/351847826198912.351641246198929/351847826198920. 351641246198937
/351847826198938. 351641246198945/351847826198946. 351641246198952/351847826198953. 351641246198960/351847826198961. 351641246198
978/351847826198979. 351641246198986/351847826198987. 351641246198994/351847826198995. 351641246199000/351847826199001. 351641246
199018/351847826199019. 351641246199026/351847826199027. 351641246199034/351847826199035. 351641246195248/351847826195249. 351641
246195255/351847826195256. 351641246195263/351847826195264. 351641246195271/351847826195272. 351641246195289/351847826195280.3516
41246195297/351847826195298. 351641246195305/351847826195306. 351641246195313/351847826195314. 351641246195321/351847826195322. 3
51641246195339/351847826195330. 351641246195347/351847826195348. 351641246195354/351847826195355. 351641246195362/351847826195363
. 351641246195370/351847826195371. 351641246195388/351847826195389. 351641246195396/351847826195397. 351641246195404/351847826195
405. 351641246195412/351847826195413. 351641246195420/351847826195421. 351641246195438/351847826195439. 351641246195446/351847826
195447. 351641246195453/351847826195454. 351641246195461/351847826195462. 351641246195479/351847826195470. 351641246195487/351847
826195488. 351641246195495/351847826195496. 351641246195503/351847826195504. 351641246195511/351847826195512. 351641246195529/351
847826195520. 351641246195537/351847826195538. 351641246195545/351847826195546. 351641246195552/351847826195553. 351641246195560/
351847826195561. 351641246195578/351847826195579. 351641246195586/351847826195587. 351641246195594/351847826195595. 3516412461956
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032025000839529-5
Espacio para uso exclusivo de la Entidad Recaudadora
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