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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
032025001146723-7
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. 116575015717755
43 . Año – Mes – Día
2025 – 06 – 21
44 . Documento de transporte
No. SHAN0396661
45 . Año – Mes – Día
2025 – 06 – 12
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
9103548810
52 . Año – Mes – Día
2025 – 06 – 12
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
249
56 . Cod. Depto
destino
0
57 . Empresa transportadora
DHL AERO EXPRESO S A SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
4.097.66
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.
129.00
72 . Peso neto kgs. dcms.
106.40
73 . Código
embalaje
YY
74 . No. bultos
2
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
400.00
78 .Valor FOB
USD
40.865.17
79 . Valor fletes USD
1.032.00 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
171.686.012
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
171.686.012
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
1.38
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.033.38
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
41.898.55
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: 561873-DECL: 1925717-DO: 893114783251- 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: 3091597178. ID DELIVERY: 6082543004. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A165MZAGLTC, PRO
DUCTO: TELEFONO CELULAR GALAXY A16 DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: GRIS, MOD(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
032025001146723
133. Feha: 202506 13
134 . Levante No. 032025000963874 135 . Fecha
2025 – 06 – 24
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 92032504575409
Fecha presentación 2025-06-13 19:50:58
Valor pagado $0.00
Fecha de Impresión: 2025-06-24 16:07:12
Page 1
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001146723-7
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ELO: SM-A165M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A165M/DS,GRAY,LTC( QTY. 400,00 u )(400,00 PCE); IM
EIS: 352042195142530/356542825142533. 352042195152018/356542825152011. 352042195152034/356542825152037. 352042195152042/356542825
152045. 352042195152232/356542825152235. 352042195152257/356542825152250. 352042195152265/356542825152268. 352042195152281/356542
825152284. 352042195152315/356542825152318. 352042195152331/356542825152334. 352042195152349/356542825152342. 352042195152356/356
542825152359. 352042195152364/356542825152367. 352042195152372/356542825152375. 352042195152646/356542825152649. 352042195152687/
356542825152680. 352042195152729/356542825152722. 352042195152745/356542825152748. 352042195152760/356542825152763. 3520421951527
86/356542825152789. 352042195152794/356542825152797. 352042195152810/356542825152813. 352042195153032/356542825153035. 3520421951
53180/356542825153183.352042195153321/356542825153324. 352042195153354/356542825153357. 3520 42195153362/356542825153365. 3520421
95153370/356542825153373. 352042195153388/356542825153381. 352042195153404/356542825153407. 352042195153438/356542825153431. 3520
42195153453/356542825153456. 352042195153503/356542825153506. 352042195153529/356542825153522. 352042195153545/356542825153548. 3
52042195153644/356542825153647. 352042195153669/356542825153662. 352042195153701/356542825153704. 352042195153735/356542825153738
. 352042195153743/356542825153746. 352042195153800/356542825153803.352042195153834/356542825153837. 352042195153859/3565428251538
52. 352042195153867/356542825153860. 352042195153891/356542825153894. 352042195153933/356542825153936. 352042195153958/3565428251
53951. 352042195153966/356542825153969. 352042195153974/356542825153977. 352042195154071/356542825154074. 352042195154097/3565428
25154090. 352042195154105/356542825154108. 352042195154279/356542825154272. 352042195154287/356542825154280. 352042195154295/3565
42825154298. 352042195154451/356542825154454. 352042195154485/356542825154488. 352042195154501/356542825154504. 352042195154519/3
56542825154512. 352042195154527/356542825154520. 352042195154535/356542825154538. 352042195154543/356542825154546. 35204219515456
8/356542825154561. 352042195154626/356542825154629. 352042195154709/356542825154702. 352042195154741/356542825154744. 35204219515
5029/356542825155022. 352042195155045/356542825155048. 352042195155268/356542825155261. 352042195155276/356542825155279. 35204219
5155284/356542825155287. 352042195155326/356542825155329. 352042195155334/356542825155337. 352042195155359/356542825155352. 35204
2195155409/356542825155402. 352042195155417/356542825155410. 352042195155656/356542825155659. 352042195155664/356542825155667. 35
2042195155789/356542825155782. 352042195155839/356542825155832. 352042195155847/356542825155840. 352042195155854/356542825155857.
352042195155862/356542825155865. 352042195155870/356542825155873. 352042195155888/356542825155881. 352042195155896/3565428251558
99. 352042195155904/356542825155907. 352042195155912/356542825155915. 352042195155979/356542825155972. 352042195156381/3565428251
56384. 352042195156498/356542825156491. 352042195156530/356542825156533. 352042195156571/356542825156574. 352042195156597/3565428
25156590.352042195156613/356542825156616. 352042195156654/356542825156657. 352042195156829/356542825156822. 352042195156837/35654
2825156830. 352042195156852/356542825156855. 352042195156878/356542825156871. 352042195156894/356542825156897. 352042195156910/35
6542825156913. 352042195156928/356542825156921. 352042195156944/356542825156947. 352042195157041/356542825157044. 352042195157058
/356542825157051. 352042195157108/356542825157101. 352042195157124/356542825157127. 352042195157132/356542825157135. 352042195157
181/356542825157184. 352042195157215/356542825157218.352042195157256/356542825157259. 352042195157264/356542825157267. 3520421951
57371/356542825157374. 352042195157413/356542825157416. 352042195157579/356542825157572. 352042195157769/356542825157762. 3520421
95157777/356542825157770. 352042195157835/356542825157838. 352042195157868/356542825157861. 352042195157876/356542825157879. 3520
42195157884/356542825157887. 352042195157942/356542825157945. 352042195158049/356542825158042. 352042195158064/356542825158067. 3
52042195158080/356542825158083. 352042195158221/356542825158224. 352042195158395/356542825158398. 352042195158528/356542825158521
. 352042195158890/356542825158893. 352042195158965/356542825158968. 352042195159088/356542825159081. 352042195159468/356542825159
461. 352042195159492/356542825159495. 352042195159559/356542825159552. 352042195159666/356542825159669. 352042195159773/356542825
159776. 352042195159815/356542825159818. 352042195160193/356542825160196. 352042195160375/356542825160378. 352042195160417/356542
825160410. 352042195160474/356542825160477. 352042195160482/356542825160485. 352042195160490/356542825160493. 352042195160516/356
542825160519. 352042195160664/356542825160667. 352042195160938/356542825160931. 352042195160953/356542825160956. 352042195161019/
356542825161012. 352042195161126/356542825161129. 352042195161274/356542825161277. 352042195161514/356542825161517. 3520421951616
13/356542825161616. 352042195161654/356542825161657. 352042195161761/356542825161764. 352042195161803/356542825161806. 3520421951
61829/356542825161822. 352042195161837/356542825161830. 352042195161985/356542825161988. 352042195161993/356542825161996. 3520421
95162074/356542825162077. 352042195162108/356542825162101. 352042195162124/356542825162127. 352042195162132/356542825162135.35204
2195162140/356542825162143. 352042195162165/356542825162168. 352042195162207/356542825162200. 352042195162231/356542825162234. 35
2042195162462/356542825162465. 352042195162496/356542825162499. 352042195162546/356542825162549. 352042195162587/356542825162580.
352042195162678/356542825162671. 352042195162728/356542825162721. 352042195162892/356542825162895. 352042195163098/3565428251630
91. 352042195163106/356542825163109. 352042195163122/356542825163125. 352042195163130/356542825163133. 352042195163155/3565428251
63158. 352042195163189/356542825163182.352042195163213/356542825163216. 352042195163528/356542825163521. 352042195163536/35654282
5163539. 352042195163601/356542825163604. 352042195163619/356542825163612. 352042195163676/356542825163679. 352042195163700/35654
2825163703. 352042195163791/356542825163794. 352042195163833/356542825163836. 352042195163841/356542825163844. 352042195163981/35
6542825163984. 352042195164351/356542825164354. 352042195164435/356542825164438. 352042195164781/356542825164784. 352042195164948
/356542825164941. 352042195165028/356542825165021. 352042195165036/356542825165039. 352042195165044/356542825165047. 352042195165
051/356542825165054. 352042195165192/356542825165195. 352042195165242/356542825165245. 352042195165291/356542825165294. 352042195
165465/356542825165468. 352042195165473/356542825165476. 352042195165580/356542825165583. 352042195165614/356542825165617. 352042
195165689/356542825165682. 352042195165820/356542825165823. 352042195165861/356542825165864. 352042195165879/356542825165872. 352
042195165945/356542825165948. 352042195165994/356542825165997. 352042195166117/356542825166110. 352042195166158/356542825166151.
352042195166232/356542825166235. 352042195166315/356542825166318. 352042195166455/356542825166458. 352042195166562/35654282516656
5. 352042195166588/356542825166581. 352042195166679/356542825166672. 352042195166927/356542825166920. 352042195167016/35654282516
7019. 352042195167024/356542825167027. 352042195167115/356542825167118. 352042195167230/356542825167233. 352042195167479/35654282
5167472. 352042195167743/356542825167746. 352042195167784/356542825167787. 352042195167800/356542825167803. 352042195167941/35654
2825167944. 352042195168022/356542825168025. 352042195168071/356542825168074. 352042195168089/356542825168082.352042195168139/356
542825168132. 352042195168147/356542825168140. 352042195168162/356542825168165. 352042195168238/356542825168231. 352042195168246/
356542825168249. 352042195168428/356542825168421. 352042195168501/356542825168504. 352042195168873/356542825168876. 3520421951689
23/356542825168926. 352042195168949/356542825168942. 352042195168956/356542825168959. 352042195168964/356542825168967. 3520421951
68972/356542825168975. 352042195168998/356542825168991. 352042195169053/356542825169056. 352042195169103/356542825169106. 3520421
95169111/356542825169114.352042195169269/356542825169262. 352042195169327/356542825169320. 352042195169335/356542825169338. 35204
2195169798/356542825169791. 352042195169889/356542825169882. 352042195169897/356542825169890. 352042195169905/356542825169908. 35
2042195169913/356542825169916. 352042195169947/356542825169940. 352042195169954/356542825169957. 352042195169996/356542825169999.
352042195170127/356542825170120. 352042195170143/356542825170146. 352042195170176/356542825170179. 352042195170200/3565428251702
03. 352042195170275/356542825170278. 352042195170473/356542825170476. 352042195170549/356542825170542. 352042195170770/3565428251
70773. 352042195170788/356542825170781. 352042195170820/356542825170823. 352042195170838/356542825170831. 352042195170879/3565428
25170872. 352042195170895/356542825170898. 352042195170903/356542825170906. 352042195171083/356542825171086. 352042195171240/3565
42825171243. 352042195171299/356542825171292. 352042195171364/356542825171367. 352042195171372/356542825171375. 352042195171398/3
56542825171391. 352042195171406/356542825171409. 352042195171539/356542825171532. 352042195171547/356542825171540. 35204219517164
6/356542825171649. 352042195172131/356542825172134. 352042195172214/356542825172217. 352042195172248/356542825172241. 35204219517
032025001146723-7
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001146723-7
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
2255/356542825172258. 352042195172321/356542825172324. 352042195172453/356542825172456. 352042195172461/356542825172464. 35204219
5172479/356542825172472. 352042195173733/356542825173736. 352042195173923/356542825173926. 352042195174020/356542825174023. 35204
2195174038/356542825174031. 352042195174046/356542825174049. 352042195174061/356542825174064. 352042195174087/356542825174080. 35
2042195174103/356542825174106. 352042195174202/356542825174205. 352042195174376/356542825174379.352042195175001/356542825175004.
352042195175100/356542825175103. 352042195175118/356542825175111. 352042195175126/356542825175129. 352042195175134/35654282517513
7. 352042195175282/356542825175285. 352042195175332/356542825175335. 352042195175357/356542825175350. 352042195175365/35654282517
5368. 352042195175399/356542825175392. 352042195175407/356542825175400. 352042195175423/356542825175426. 352042195175449/35654282
5175442. 352042195175464/356542825175467. 352042195175472/356542825175475. 352042195175480/356542825175483. 352042195175506/35654
2825175509.352042195175589/356542825175582. 352042195175720/356542825175723. 352042195175746/356542825175749. 352042195175811/356
542825175814. 352042195176033/356542825176036. 352042195176124/356542825176127. 352042195176173/356542825176176. 352042195176223/
356542825176226. 352042195176249/356542825176242. 352042195176280/356542825176283. 352042195176306/356542825176309. 3520421951763
63/356542825176366. 352042195176371/356542825176374. 352042195176397/356542825176390. 352042195176421/356542825176424. 3520421951
76488/356542825176481. 352042195176538/356542825176531. 352042195176553/356542825176556. 352042195176694/356542825176697. 3520421
95176702/356542825176705. 352042195176728/356542825176721. 352042195176736/356542825176739. 352042195176777/356542825176770. 3520
42195176835/356542825176838. 352042195176900/356542825176903. 352042195176926/356542825176929. 352042195176934/356542825176937. 3
52042195176942/356542825176945. 352042195176959/356542825176952. 352042195176967/356542825176960. 352042195176983/356542825176986
. 352042195177015/356542825177018. 352042195177023/356542825177026. 352042195177171/356542825177174. 352042195177197/356542825177
190. 352042195177205/356542825177208. 352042195177239/356542825177232. 352042195177320/356542825177323. 352042195177338/356542825
177331. 352042195177346/356542825177349. 352042195177361/356542825177364. 352042195177502/356542825177505. 352042195177510/356542
825177513. 352042195177684/356542825177687. 352042195177841/356542825177844. 352042195177908/356542825177901. 352042195177924/356
542825177927. 352042195177999/356542825177992. 352042195178039/356542825178032. 352042195178179/356542825178172. 352042195178435/
356542825178438. 352042195178526/356542825178529. 352042195178666/356542825178669.352042195178831/356542825178834. 35204219517887
2/356542825178875. 352042195179169/356542825179162. 352042195179532/356542825179535. 352042195179649/356542825179642. 35204219517
9664/356542825179667. 352042195179698/356542825179691. 352042195179706/356542825179709. 352042195179748/356542825179741. 35204219
5179755/356542825179758. 352042195179904/356542825179907. 352042195180027/356542825180020. 352042195180365/356542825180368. 35204
2195180688/356542825180681. 352042195180696/356542825180699. 352042195180811/356542825180814. 352042195180860/356542825180863.352
042195180993/356542825180996. 352042195181108/356542825181101. 352042195181116/356542825181119. 352042195181314/356542825181317.
352042195181330/356542825181333. 352042195181405/356542825181408. 352042195181421/356542825181424. 352042195181447/35654282518144
0. 352042195181462/356542825181465XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025001146723-7
Espacio para uso exclusivo de la Entidad Recaudadora
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