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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
032025001093385-1
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. 116575015676088
43 . Año – Mes – Día
2025 – 06 – 10
44 . Documento de transporte
No. 41N0704513
45 . Año – Mes – Día
2025 – 05 – 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
6900365861
52 . Año – Mes – Día
2025 – 05 – 23
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.
4.106.79
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.
145.00
72 . Peso neto kgs. dcms.
116.53
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
430.00
78 .Valor FOB
USD
24.328.04
79 . Valor fletes USD
1.045.45 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
104.207.045
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
104.207.045
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
0.84
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.046.29
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
25.374.33
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: 560750-DECL: 1922311-DO: 893113951251- 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. EMITIDO POR LA COMISIÓN DE REGULACIÓN DE COMUNICACIONES (ANEXAMOS CERTIFICADO DE HOMOL
OGACIÓN)// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA
S.A. OEA COD. OE0001. . PEDIDOS: 3090069310. ID DELIVERY: 6082332708. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A055MZSDLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A05 DUOS (CON ACCESORIOSPARA USO Y NORMAL FUNCIONAMIENTO), COLOR: PLATA, MODEL(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
032025001093385
133. Feha: 202506 06
134 . Levante No. 032025000904145 135 . Fecha
2025 – 06 – 11
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 92032504377298
Fecha presentación 2025-06-06 16:02:18
Valor pagado $0.00
Fecha de Impresión: 2025-06-11 09:44:11
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001093385-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
O: SM-A055M/DS,USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A055M/DS,SILVER,LTC( QTY. 430,00 u )(430,00 PCE); IME
IS: 351641248170918/351847828170919. 351641248181840/351847828181841. 351641248186005/351847828186006. 351641248186815/3518478281
86816. 351641248187714/351847828187715. 351641248188076/351847828188077. 351641248188290/351847828188291.351641248188399/35184782
8188390. 351641248188555/351847828188556. 351641248188662/351847828188663. 351641248188829/351847828188820. 351641248189199/35184
7828189190. 351641248200186/351847828200187. 351641248200731/351847828200732. 351641248202265/351847828202266. 351641248202406/35
1847828202407. 351641248202547/351847828202548. 351641248202943/351847828202944. 351641248203016/351847828203017. 351641248203206
/351847828203207. 351641248203248/351847828203249. 351641248203586/351847828203587. 351641248203610/351847828203611. 351641248203
727/351847828203728.351641248204063/351847828204064. 351641248204287/351847828204288. 351 641248204618/351847828204619. 351641248
204717/351847828204718. 351641248205037/351847828205038. 351641248205078/351847828205079. 351641248205151/351847828205152. 351641
248205219/351847828205210. 351641248205235/351847828205236. 351641248205243/351847828205244. 351641248205250/351847828205251. 351
641248205268/351847828205269. 351641248205284/351847828205285. 351641248205292/351847828205293. 351641248205300/351847828205301.
351641248205326/351847828205327. 351641248205375/351847828205376. 351641248205383/351847828205384. 351641248205409/35184782820540
0. 351641248205425/351847828205426. 351641248205433/351847828205434. 351641248205441/351847828205442. 351641248205458/35184782820
5459. 351641248205466/351847828205467. 351641248205474/351847828205475. 351641248205482/351847828205483. 351641248205490/35184782
8205491. 351641248205508/351847828205509. 351641248205516/351847828205517. 351641248205532/351847828205533. 351641248205540/35184
7828205541. 351641248205557/351847828205558. 351641248205565/351847828205566. 351641248205573/351847828205574. 351641248205581/35
1847828205582. 351641248205599/351847828205590. 351641248205607/351847828205608. 351641248205615/351847828205616. 351641248205623
/351847828205624. 351641248205631/351847828205632. 351641248205656/351847828205657. 351641248205664/351847828205665. 351641248205
672/351847828205673. 351641248205680/351847828205681. 351641248205698/351847828205699. 351641248205706/351847828205707. 351641248
205722/351847828205723. 351641248205748/351847828205749. 351641248205755/351847828205756. 351641248205789/351847828205780. 351641
248205797/351847828205798. 351641248205805/351847828205806. 351641248205813/351847828205814.351641248205854/351847828205855. 3516
41248205862/351847828205863. 351641248205920/351847828205921. 351641248206191/351847828206192. 351641248206373/351847828206374. 3
51641248206381/351847828206382. 351641248206407/351847828206408. 351641248206423/351847828206424. 351641248206431/351847828206432
. 351641248206456/351847828206457. 351641248206464/351847828206465. 351641248206472/351847828206473. 351641248206480/351847828206
481. 351641248206498/351847828206499. 351641248206514/351847828206515. 351641248206522/351847828206523. 351641248206530/351847828
206531.351641248206548/351847828206549. 351641248206555/351847828206556. 351641248206563/351847828206564. 351641248206571/3518478
28206572. 351641248206589/351847828206580. 351641248206597/351847828206598. 351641248206605/351847828206606. 351641248206613/3518
47828206614. 351641248206621/351847828206622. 351641248206639/351847828206630. 351641248206654/351847828206655. 351641248206670/3
51847828206671. 351641248206688/351847828206689. 351641248206696/351847828206697. 351641248206704/351847828206705. 35164124820671
2/351847828206713. 351641248206720/351847828206721. 351641248206738/351847828206739. 351641248206746/351847828206747. 35164124820
6753/351847828206754. 351641248206761/351847828206762. 351641248206779/351847828206770. 351641248206787/351847828206788. 35164124
8206795/351847828206796. 351641248206803/351847828206804. 351641248206811/351847828206812. 351641248206829/351847828206820. 35164
1248206837/351847828206838. 351641248206845/351847828206846. 351641248206852/351847828206853. 351641248206860/351847828206861. 35
1641248206878/351847828206879. 351641248206886/351847828206887. 351641248206902/351847828206903. 351641248206928/351847828206929.
351641248206936/351847828206937. 351641248206944/351847828206945. 351641248206951/351847828206952. 351641248206977/3518478282069
78. 351641248206985/351847828206986. 351641248207009/351847828207000. 351641248207025/351847828207026. 351641248207033/3518478282
07034. 351641248207041/351847828207042. 351641248207058/351847828207059. 351641248207074/351847828207075. 351641248207116/3518478
28207117. 351641248207124/351847828207125. 351641248207157/351847828207158. 351641248207173/351847828207174. 351641248207207/3518
47828207208. 351641248207231/351847828207232. 351641248207249/351847828207240.351641248207256/351847828207257. 351641248207264/35
1847828207265. 351641248207272/351847828207273. 351641248207280/351847828207281. 351641248207298/351847828207299. 351641248207314
/351847828207315. 351641248207322/351847828207323. 351641248207330/351847828207331. 351641248207520/351847828207521. 351641248207
538/351847828207539. 351641248207637/351847828207638. 351641248207652/351847828207653. 351641248207686/351847828207687. 351641248
207702/351847828207703. 351641248207785/351847828207786. 351641248207843/351847828207844. 351641248207850/351847828207851.3516412
48207876/351847828207877. 351641248207934/351847828207935. 351641248208080/351847828208081. 351641248208098/351847828208099. 3516
41248208106/351847828208107. 351641248208122/351847828208123. 351641248208130/351847828208131. 351641248208148/351847828208149. 3
51641248208155/351847828208156. 351641248208163/351847828208164. 351641248208171/351847828208172. 351641248208189/351847828208180
. 351641248208197/351847828208198. 351641248208205/351847828208206. 351641248208213/351847828208214. 351641248208221/351847828208
222. 351641248208262/351847828208263. 351641248208270/351847828208271. 351641248208304/351847828208305. 351641248208312/351847828
208313. 351641248208338/351847828208339. 351641248208346/351847828208347. 351641248208361/351847828208362. 351641248208403/351847
828208404. 351641248208411/351847828208412. 351641248208429/351847828208420. 351641248208437/351847828208438. 351641248208452/351
847828208453. 351641248208460/351847828208461. 351641248208478/351847828208479. 351641248208486/351847828208487. 351641248208494/
351847828208495. 351641248208502/351847828208503. 351641248208510/351847828208511. 351641248208528/351847828208529. 3516412482085
36/351847828208537. 351641248208551/351847828208552. 351641248208569/351847828208560. 351641248208577/351847828208578. 3516412482
08585/351847828208586. 351641248208601/351847828208602. 351641248208700/351847828208701. 351641248208726/351847828208727. 3516412
48208734/351847828208735. 351641248208742/351847828208743. 351641248208759/351847828208750. 351641248208767/351847828208768. 3516
41248208775/351847828208776. 351641248208783/351847828208784. 351641248208809/351847828208800. 351641248208833/351847828208834. 3
51641248208841/351847828208842. 351641248208858/351847828208859.351641248208866/351847828208867. 351641248208874/351847828208875.
351641248208882/351847828208883. 351641248208890/351847828208891. 351641248208957/351847828208958. 351641248208973/3518478282089
74. 351641248208999/351847828208990. 351641248209005/351847828209006. 351641248209013/351847828209014. 351641248209039/3518478282
09030. 351641248209047/351847828209048. 351641248209054/351847828209055. 351641248209062/351847828209063. 351641248209070/3518478
28209071. 351641248209088/351847828209089. 351641248209096/351847828209097. 351641248209104/351847828209105.351641248209112/35184
7828209113. 351641248209120/351847828209121. 351641248209146/351847828209147. 351641248209153/351847828209154. 351641248209161/35
1847828209162. 351641248209179/351847828209170. 351641248209187/351847828209188. 351641248209195/351847828209196. 351641248209203
/351847828209204. 351641248209211/351847828209212. 351641248209229/351847828209220. 351641248209237/351847828209238. 351641248209
245/351847828209246. 351641248209252/351847828209253. 351641248209260/351847828209261. 351641248209278/351847828209279. 351641248
209294/351847828209295. 351641248209310/351847828209311. 351641248209690/351847828209691. 351641248209716/351847828209717. 351641
248209724/351847828209725. 351641248209732/351847828209733. 351641248209740/351847828209741. 351641248209757/351847828209758. 351
641248209765/351847828209766. 351641248209773/351847828209774. 351641248209781/351847828209782. 351641248209807/351847828209808.
351641248209823/351847828209824. 351641248209831/351847828209832. 351641248209849/351847828209840. 351641248209856/35184782820985
7. 351641248209864/351847828209865. 351641248209872/351847828209873. 351641248209880/351847828209881. 351641248209898/35184782820
9899. 351641248209914/351847828209915. 351641248210391/351847828210392. 351641248212751/351847828212752. 351641248214724/35184782
8214725. 351641248217230/351847828217231. 351641248217537/351847828217538. 351641248217545/351847828217546. 351641248217578/35184
7828217579. 351641248217610/351847828217611. 351641248217636/351847828217637. 351641248217651/351847828217652. 351641248217669/35
1847828217660. 351641248217677/351847828217678. 351641248217685/351847828217686. 351641248217693/351847828217694. 351641248217727
/351847828217728. 351641248217750/351847828217751.351641248217818/351847828217819. 351641248217834/351847828217835. 3516412482178
032025001093385-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001093385-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
59/351847828217850. 351641248217867/351847828217868. 351641248217875/351847828217876. 351641248217883/351847828217884. 3516412482
17891/351847828217892. 351641248217909/351847828217900. 351641248217917/351847828217918. 351641248217925/351847828217926. 3516412
48217941/351847828217942. 351641248217958/351847828217959. 351641248217966/351847828217967. 351641248217974/351847828217975. 3516
41248217982/351847828217983. 351641248218006/351847828218007. 351641248218014/351847828218015.351641248218022/351847828218023. 35
1641248218030/351847828218031. 351641248218048/351847828218049. 351641248218055/351847828218056. 351641248218063/351847828218064.
351641248218071/351847828218072. 351641248218097/351847828218098. 351641248218139/351847828218130. 351641248218147/3518478282181
48. 351641248218154/351847828218155. 351641248218162/351847828218163. 351641248218196/351847828218197. 351641248218220/3518478282
18221. 351641248218238/351847828218239. 351641248218246/351847828218247. 351641248218253/351847828218254. 351641248218279/3518478
28218270. 351641248218303/351847828218304. 351641248218345/351847828218346. 351641248218402/351847828218403. 351641248218410/3518
47828218411. 351641248218444/351847828218445. 351641248218469/351847828218460. 351641248218477/351847828218478. 351641248218493/3
51847828218494. 351641248218501/351847828218502. 351641248218527/351847828218528. 351641248218543/351847828218544. 35164124821881
6/351847828218817. 351641248218824/351847828218825. 351641248218832/351847828218833. 351641248218840/351847828218841. 35164124821
8865/351847828218866. 351641248218881/351847828218882. 351641248220309/351847828220300. 351641248220515/351847828220516. 35164124
8220721/351847828220722. 351641248220739/351847828220730. 351641248220754/351847828220755. 351641248220804/351847828220805. 35164
1248220879/351847828220870. 351641248220895/351847828220896. 351641248220903/351847828220904. 351641248220929/351847828220920. 35
1641248220937/351847828220938. 351641248220945/351847828220946. 351641248220952/351847828220953. 351641248220960/351847828220961.
351641248220978/351847828220979. 351641248221018/351847828221019. 351641248221026/351847828221027. 351641248221034/3518478282210
35. 351641248221042/351847828221043.351641248221083/351847828221084. 351641248221091/351847828221092. 351641248221117/35184782822
1118. 351641248221125/351847828221126. 351641248221133/351847828221134. 351641248221141/351847828221142. 351641248221158/35184782
8221159. 351641248221182/351847828221183. 351641248221190/351847828221191. 351641248222958/351847828222959. 351641248223592/35184
7828223593. 351641248223600/351847828223601. 351641248223626/351847828223627. 351641248223808/351847828223809. 351641248223816/35
1847828223817. 351641248223824/351847828223825. 351641248223840/351847828223841.351641248223873/351847828223874. 351641248223881/
351847828223882. 351641248228237/351847828228238. 351641248228377/351847828228378. 351641248228385/351847828228386. 3516412482286
25/351847828228626. 351641248228708/351847828228709. 351641248228716/351847828228717. 351641248229078/351847828229079. 3516412482
29326/351847828229327. 351641248229334/351847828229335. 351641248229367/351847828229368. 351641248229474/351847828229475. 3516412
48229482/351847828229483. 351641248229524/351847828229525. 351641248229557/351847828229558. 351641248230506/351847828230507. 3516
41248230548/351847828230549. 351641248230555/351847828230556. 351641248230605/351847828230606. 351641248230654/351847828230655. 3
51641248230795/351847828230796. 351641248230811/351847828230812. 351641248230829/351847828230820. 351641248230837/351847828230838
. 351641248230845/351847828230846. 351641248230852/351847828230853. 351641248230878/351847828230879. 351641248230910/351847828230
911. 351641248230993/351847828230994. 351641248231066/351847828231067. 351641248231082/351847828231083. 351641248231090/351847828
231091. 351641248231124/351847828231125. 351641248231454/351847828231455. 351641248232197/351847828232198. 351641248232247/351847
828232248. 351641248232312/351847828232313. 351641248232833/351847828232834. 351641248232965/351847828232966. 351641248232973/351
847828232974. 351641248233138/351847828233139. 351641248233393/351847828233394. 351641248233476/351847828233477. 351641248233641/
351847828233642. 351641248233997/351847828233998. 351641248234037/351847828234038. 351641248234094/351847828234095. 3516412482342
68/351847828234269. 351641248234276/351847828234277. 351641248234441/351847828234442. 351641248234615/351847828234616. 3516412482
34805/351847828234806.351641248235000/351847828235001. 351641248235083/351847828235084. 351641248235141/351847828235142XXXXXXXXXX
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032025001093385-1
Espacio para uso exclusivo de la Entidad Recaudadora
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