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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
032025001453281-1
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. 116575015898831
43 . Año – Mes – Día
2025 – 08 – 08
44 . Documento de transporte
No. SHAN0409677
45 . Año – Mes – Día
2025 – 08 – 02
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
9103675675
52 . Año – Mes – Día
2025 – 08 – 02
53 . Cod. país
procedencia
855
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.
4.186.71
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.
130.00
72 . Peso neto kgs. dcms.
108.40
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
55.523.82
79 . Valor fletes USD
1.047.80 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
236.856.796
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
236.856.796
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
1.87
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.049.67
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
56.573.49
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: 568176-DECL: 1942425-DO: 893119429251- 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: 3095408758. ID DELIVERY: 6083653886. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A266MZKHLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A26 5G DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, 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
032025001453281
133. Feha: 202508 06
134 . Levante No. 032025001217919 135 . Fecha
2025 – 08 – 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 92032506060422
Fecha presentación 2025-08-06 17:48:29
Valor pagado $0.00
Fecha de Impresión: 2025-08-11 13:23:07
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001453281-1
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
ODELO: SM-A266M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL./ /MOBILE,SM-A266M/DS,BLACK,LTC( QTY. 400,00 u )(400,00 PCE)
; IMEIS: 351813978903681/352975138903684. 351813978905827/352975138905820. 351813978906098/352975138906091. 351813978906726/35297
5138906729. 351813978907583/352975138907586. 351813978947696/352975138947699. 351813978949320/352975138949323. 351813978949767/35
2975138949760. 351813978950476/352975138950479.351813978950567/352975138950560. 351813978951219/352975138951212. 351813978951474/
352975138951477. 351813978951664/352975138951667. 351813978955434/352975138955437. 351813978957224/352975138957227. 3518139789604
00/352975138960403. 351813978961051/352975138961054. 351813978963859/352975138963852. 351813978969153/352975138969156. 3518139789
72421/352975138972424. 351813978977131/352975138977134. 351813978977289/352975138977282. 351813978978212/352975138978215. 3518139
78978220/352975138978223. 351813978978238/352975138978231. 351813978978477/352975138978470. 351813978978550/352975138978553. 3518
13978979244/352975138979247. 351813978985647/352975138985640. 351813978985688/352975138985681. 351813978985696/352975138985699. 3
51813978985712/352975138985715. 351813978985720/352975138985723. 351813978985746/352975138985749. 351813978985753/352975138985756
. 351813978985787/352975138985780. 351813978985795/352975138985798. 351813978985860/352975138985863. 351813978985878/352975138985
871. 351813978985902/352975138985905. 351813978985910/352975138985913. 351813978985936/352975138985939. 351813978985944/352975138
985947. 351813978985951/352975138985954. 351813978985993/352975138985996. 351813978986009/352975138986002. 351813978986033/352975
138986036. 351813978986074/352975138986077. 351813978986090/352975138986093. 351813978986116/352975138986119. 351813978986223/352
975138986226. 351813978986249/352975138986242. 351813978986256/352975138986259. 351813978986264/352975138986267. 351813978986272/
352975138986275. 351813978986280/352975138986283. 351813978986298/352975138986291. 351813978986306/352975138986309. 3518139789863
14/352975138986317. 351813978986330/352975138986333. 351813978986371/352975138986374. 351813978986413/352975138986416. 3518139789
86439/352975138986432. 351813978986447/352975138986440. 351813978986462/352975138986465. 351813978986488/352975138986481. 3518139
78986496/352975138986499. 351813978986504/352975138986507. 351813978986553/352975138986556. 351813978986579/352975138986572. 3518
13978986603/352975138986606. 351813978986660/352975138986663. 351813978986736/352975138986739. 351813978986744/352975138986747. 3
51813978986793/352975138986796. 351813978986876/352975138986879. 351813978986884/352975138986887. 351813978986926/352975138986929
. 351813978986983/352975138986986.351813978987015/352975138987018. 351813978987023/352975138987026. 351813978987049/3529751389870
42. 351813978987056/352975138987059. 351813978987098/352975138987091. 351813978987106/352975138987109. 351813978987122/3529751389
87125. 351813978987130/352975138987133. 351813978987148/352975138987141. 351813978987155/352975138987158. 351813978987163/3529751
38987166. 351813978987171/352975138987174. 351813978987189/352975138987182. 351813978987197/352975138987190. 351813978987205/3529
75138987208. 351813978987213/352975138987216. 351813978987221/352975138987224.351813978987239/352975138987232. 351813978987270/35
2975138987273. 351813978987296/352975138987299. 351813978987395/352975138987398. 351813978987452/352975138987455. 351813978987627
/352975138987620. 351813978987635/352975138987638. 351813978987643/352975138987646. 351813978987692/352975138987695. 351813978987
718/352975138987711. 351813978987809/352975138987802. 351813978987833/352975138987836. 351813978987916/352975138987919. 351813978
988039/352975138988032. 351813978988054/352975138988057. 351813978988088/352975138988081. 351813978988096/352975138988099. 351813
978988104/352975138988107. 351813978988187/352975138988180. 351813978988195/352975138988198. 351813978988203/352975138988206. 351
813978988641/352975138988644. 351813978988666/352975138988669. 351813978988740/352975138988743. 351813978988971/352975138988974.
351813978988989/352975138988982. 351813978989011/352975138989014. 351813978989144/352975138989147. 351813978989151/35297513898915
4. 351813978989219/352975138989212. 351813978989227/352975138989220. 351813978989235/352975138989238. 351813978989243/35297513898
9246. 351813978989268/352975138989261. 351813978989276/352975138989279. 351813978989284/352975138989287. 351813978989300/35297513
8989303. 351813978989367/352975138989360. 351813978989375/352975138989378. 351813978989417/352975138989410. 351813978989508/35297
5138989501. 351813978989516/352975138989519. 351813978989524/352975138989527. 351813978989557/352975138989550. 351813978989573/35
2975138989576. 351813978989680/352975138989683. 351813978989839/352975138989832. 351813978989862/352975138989865. 351813978989896
/352975138989899. 351813978989912/352975138989915. 351813978989920/352975138989923. 351813978989938/352975138989931. 351813978989
953/352975138989956.351813978989961/352975138989964. 351813978989987/352975138989980. 351813978990068/352975138990061. 3518139789
90084/352975138990087. 351813978990191/352975138990194. 351813978990217/352975138990210. 351813978990415/352975138990418. 3518139
78990431/352975138990434. 351813978990449/352975138990442. 351813978990456/352975138990459. 351813978990464/352975138990467. 3518
13978990498/352975138990491. 351813978990506/352975138990509. 351813978990522/352975138990525. 351813978990530/352975138990533. 3
51813978990571/352975138990574. 351813978990589/352975138990582.351813978990597/352975138990590. 351813978990613/352975138990616.
351813978990621/352975138990624. 351813978990647/352975138990640. 351813978990654/352975138990657. 351813978990753/3529751389907
56. 351813978990761/352975138990764. 351813978990787/352975138990780. 351813978990803/352975138990806. 351813978991033/3529751389
91036. 351813978991066/352975138991069. 351813978991074/352975138991077. 351813978991082/352975138991085. 351813978991116/3529751
38991119. 351813978991124/352975138991127. 351813978991157/352975138991150. 351813978991165/352975138991168. 351813978991223/3529
75138991226. 351813978991249/352975138991242. 351813978991306/352975138991309. 351813978991314/352975138991317. 351813978991322/3
52975138991325. 351813978991330/352975138991333. 351813978991348/352975138991341. 351813978991389/352975138991382. 35181397899140
5/352975138991408. 351813978991421/352975138991424. 351813978991454/352975138991457. 351813978991561/352975138991564. 35181397899
1587/352975138991580. 351813978991645/352975138991648. 351813978991785/352975138991788. 351813978991843/352975138991846. 35181397
8991900/352975138991903. 351813978992189/352975138992182. 351813978992254/352975138992257. 351813978992296/352975138992299. 35181
3978992304/352975138992307. 351813978992346/352975138992349. 351813978992353/352975138992356. 351813978992379/352975138992372. 35
1813978992387/352975138992380. 351813978992437/352975138992430. 351813978992452/352975138992455. 351813978992460/352975138992463.
351813978992536/352975138992539. 351813978992593/352975138992596. 351813978992742/352975138992745. 351813978992767/3529751389927
60. 351813978992783/352975138992786. 351813978992841/352975138992844. 351813978992874/352975138992877. 351813978993047/3529751389
93040.351813978993112/352975138993115. 351813978993120/352975138993123. 351813978993138/352975138993131. 351813978993146/35297513
8993149. 351813978993229/352975138993222. 351813978993237/352975138993230. 351813978993286/352975138993289. 351813978993351/35297
5138993354. 351813978993385/352975138993388. 351813978993393/352975138993396. 351813978993427/352975138993420. 351813978993435/35
2975138993438. 351813978993443/352975138993446. 351813978993476/352975138993479. 351813978993484/352975138993487. 351813978993492
/352975138993495. 351813978993500/352975138993503.351813978993542/352975138993545. 351813978993583/352975138993586. 3518139789936
25/352975138993628. 351813978993658/352975138993651. 351813978993690/352975138993693. 351813978993724/352975138993727. 3518139789
93740/352975138993743. 351813978993773/352975138993776. 351813978993831/352975138993834. 351813978993898/352975138993891. 3518139
78993914/352975138993917. 351813978993971/352975138993974. 351813978994003/352975138994006. 351813978994011/352975138994014. 3518
13978994045/352975138994048. 351813978994078/352975138994071. 351813978994110/352975138994113. 351813978994169/352975138994162. 3
51813978994185/352975138994188. 351813978994284/352975138994287. 351813978994300/352975138994303. 351813978994326/352975138994329
. 351813978994359/352975138994352. 351813978994383/352975138994386. 351813978994391/352975138994394. 351813978994417/352975138994
410. 351813978994425/352975138994428. 351813978994458/352975138994451. 351813978994474/352975138994477. 351813978994482/352975138
994485. 351813978994516/352975138994519. 351813978994631/352975138994634. 351813978994714/352975138994717. 351813978994789/352975
138994782. 351813978994821/352975138994824. 351813978994839/352975138994832. 351813978994896/352975138994899. 351813978994912/352
975138994915. 351813978994920/352975138994923. 351813978994938/352975138994931. 351813978995190/352975138995193. 351813978995901/
352975138995904. 351813978996347/352975138996340. 351813978996438/352975138996431. 351813978996511/352975138996514. 3518139789967
19/352975138996712. 351813978996891/352975138996894. 351813978997113/352975138997116. 351813978997139/352975138997132. 3518139789
97329/352975138997322. 351813978997394/352975138997397. 351813978997428/352975138997421. 351813978997451/352975138997454.35181397
032025001453281-1
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001453281-1
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
8997493/352975138997496. 351813978997550/352975138997553. 351813978997774/352975138997777. 351813978997808/352975138997801. 35181
3978997824/352975138997827. 351813978997857/352975138997850. 351813978997915/352975138997918. 351813978997998/352975138997991. 35
1813978998004/352975138998007. 351813978998012/352975138998015. 351813978998038/352975138998031. 351813978998053/352975138998056.
351813978998079/352975138998072. 351813978998186/352975138998189. 351813978998194/352975138998197. 351813978998210/3529751389982
13. 351813978998228/352975138998221.351813978998277/352975138998270. 351813978998327/352975138998320. 351813978998376/35297513899
8379. 351813978998384/352975138998387. 351813978998392/352975138998395. 351813978998418/352975138998411. 351813978998426/35297513
8998429. 351813978998442/352975138998445. 351813978998467/352975138998460. 351813978998483/352975138998486. 351813978998491/35297
5138998494. 351813978998509/352975138998502. 351813978998517/352975138998510. 351813978998525/352975138998528. 351813978998566/35
2975138998569. 351813978998632/352975138998635. 351813978998707/352975138998700. 351813978998855/352975138998858. 351813978998863
/352975138998866. 351813978998871/352975138998874. 351813978998905/352975138998908. 351813978998913/352975138998916. 351813978998
921/352975138998924. 351813978998988/352975138998981. 351813978998996/352975138998999. 351813978999010/352975138999013. 351813978
999028/352975138999021. 351813978999051/352975138999054. 351813978999101/352975138999104. 351813978999143/352975138999146. 351813
978999168/352975138999161. 351813978999176/352975138999179. 351813978999184/352975138999187. 351813978999218/352975138999211. 351
813978999291/352975138999294. 351813978999309/352975138999302. 351813978999317/352975138999310. 351813978999325/352975138999328.
351813978999333/352975138999336. 351813978999341/352975138999344. 351813978999358/352975138999351. 351813978999390/35297513899939
3. 351813978999408/352975138999401. 351813978999416/352975138999419. 351813978999465/352975138999468. 351813978999499/35297513899
9492. 351813978999531/352975138999534. 351813978999556/352975138999559. 351813978999622/352975138999625. 351813978999689/35297513
8999682. 351813978999705/352975138999708. 351813978999739/352975138999732. 351813978999937/352975138999930.351813979000115/352975
139000118. 351813979000123/352975139000126. 351813979000172/352975139000175. 351813979000180/352975139000183. 351813979000206/352
975139000209. 351813979000248/352975139000241. 351813979000289/352975139000282. 351813979000362/352975139000365. 351813979000388/
352975139000381. 351813979000453/352975139000456. 351813979000552/352975139000555. 351813979000560/352975139000563. 3518139790005
78/352975139000571. 351813979000594/352975139000597. 351813979000602/352975139000605. 351813979000636/352975139000639. 3518139790
00727/352975139000720.351813979000750/352975139000753. 351813979000776/352975139000779. 351813979000792/352975139000795. 35181397
9000800/352975139000803. 351813979000875/352975139000878. 351813979000958/352975139000951. 351813979000966/352975139000969. 35181
3979000990/352975139000993. 351813979001014/352975139001017. 351813979001030/352975139001033. 351813979001055/352975139001058. 35
1813979001105/352975139001108. 351813979001188/352975139001181. 351813979001261/352975139001264. 351813979001303/352975139001306.
351813979001311/352975139001314. 351813979001329/352975139001322. 351813979001386/352975139001389. 351813979001394/3529751390013
97. 351813979001402/352975139001405. 351813979001477/352975139001470. 351813979001543/352975139001546. 351813979001550/3529751390
01553. 351813979061075/352975139061078XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
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032025001453281-1
Espacio para uso exclusivo de la Entidad Recaudadora
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