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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
032025001453868-2
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. SHAN0409676
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
9103675674
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.
129.50
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
55.527.85
79 . Valor fletes USD
1.043.77 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
1.045.64
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: 568173-DECL: 1942403-DO: 893119428251- 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: 3095409851. ID DELIVERY: 6083653085. 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
032025001453868
133. Feha: 202508 06
134 . Levante No. 032025001217993 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 92032506064591
Fecha presentación 2025-08-06 19:57:07
Valor pagado $0.00
Fecha de Impresión: 2025-08-11 13:28:40
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001453868-2
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: 351813978903137/352975138903130. 351813978904879/352975138904872. 351813978905280/352975138905283. 351813978949726/35297
5138949729. 351813978959618/352975138959611. 351813978975010/352975138975013. 351813978978667/352975138978660. 351813978978832/35
2975138978835. 351813978985613/352975138985616.351813978985639/352975138985632. 351813978985662/352975138985665. 351813978985803/
352975138985806. 351813978985886/352975138985889. 351813978985928/352975138985921. 351813978986025/352975138986028. 3518139789861
24/352975138986127. 351813978986173/352975138986176. 351813978986231/352975138986234. 351813978986363/352975138986366. 3518139789
86397/352975138986390. 351813978986470/352975138986473. 351813978986512/352975138986515. 351813978986538/352975138986531. 3518139
78986595/352975138986598. 351813978986652/352975138986655. 351813978986686/352975138986689. 351813978986785/352975138986788. 3518
13978986801/352975138986804. 351813978986819/352975138986812. 351813978986827/352975138986820. 351813978986835/352975138986838. 3
51813978986843/352975138986846. 351813978986918/352975138986911. 351813978986942/352975138986945. 351813978987288/352975138987281
. 351813978987346/352975138987349. 351813978987379/352975138987372. 351813978987387/352975138987380. 351813978987403/352975138987
406. 351813978987429/352975138987422. 351813978987486/352975138987489. 351813978987510/352975138987513. 351813978987528/352975138
987521. 351813978987536/352975138987539. 351813978987551/352975138987554. 351813978987577/352975138987570. 351813978987585/352975
138987588. 351813978987593/352975138987596. 351813978987619/352975138987612. 351813978987650/352975138987653. 351813978987742/352
975138987745. 351813978987759/352975138987752. 351813978987775/352975138987778. 351813978987791/352975138987794. 351813978987817/
352975138987810. 351813978987858/352975138987851. 351813978987874/352975138987877. 351813978987890/352975138987893. 3518139789880
13/352975138988016. 351813978988070/352975138988073. 351813978988112/352975138988115. 351813978988120/352975138988123. 3518139789
88138/352975138988131. 351813978988153/352975138988156. 351813978988260/352975138988263. 351813978988278/352975138988271. 3518139
78988302/352975138988305. 351813978988310/352975138988313. 351813978988344/352975138988347. 351813978988377/352975138988370. 3518
13978988401/352975138988404. 351813978988419/352975138988412. 351813978988500/352975138988503. 351813978988567/352975138988560. 3
51813978988633/352975138988636. 351813978988658/352975138988651. 351813978988708/352975138988701. 351813978988724/352975138988727
. 351813978988823/352975138988826.351813978988849/352975138988842. 351813978988856/352975138988859. 351813978988864/3529751389888
67. 351813978988880/352975138988883. 351813978988898/352975138988891. 351813978988914/352975138988917. 351813978988922/3529751389
88925. 351813978988948/352975138988941. 351813978988955/352975138988958. 351813978988963/352975138988966. 351813978989029/3529751
38989022. 351813978989045/352975138989048. 351813978989110/352975138989113. 351813978989128/352975138989121. 351813978989136/3529
75138989139. 351813978989193/352975138989196. 351813978989201/352975138989204.351813978989250/352975138989253. 351813978989292/35
2975138989295. 351813978989318/352975138989311. 351813978989326/352975138989329. 351813978989334/352975138989337. 351813978989359
/352975138989352. 351813978989391/352975138989394. 351813978989441/352975138989444. 351813978989458/352975138989451. 351813978989
466/352975138989469. 351813978989474/352975138989477. 351813978989490/352975138989493. 351813978989540/352975138989543. 351813978
989565/352975138989568. 351813978989581/352975138989584. 351813978989607/352975138989600. 351813978989615/352975138989618. 351813
978989649/352975138989642. 351813978989656/352975138989659. 351813978989664/352975138989667. 351813978989698/352975138989691. 351
813978989706/352975138989709. 351813978989755/352975138989758. 351813978989763/352975138989766. 351813978989805/352975138989808.
351813978989821/352975138989824. 351813978989847/352975138989840. 351813978989870/352975138989873. 351813978989888/35297513898988
1. 351813978990001/352975138990004. 351813978990035/352975138990038. 351813978990043/352975138990046. 351813978990076/35297513899
0079. 351813978990100/352975138990103. 351813978990118/352975138990111. 351813978990126/352975138990129. 351813978990134/35297513
8990137. 351813978990142/352975138990145. 351813978990159/352975138990152. 351813978990175/352975138990178. 351813978990233/35297
5138990236. 351813978990241/352975138990244. 351813978990258/352975138990251. 351813978990266/352975138990269. 351813978990274/35
2975138990277. 351813978990290/352975138990293. 351813978990308/352975138990301. 351813978990365/352975138990368. 351813978990381
/352975138990384. 351813978990472/352975138990475. 351813978990480/352975138990483. 351813978990514/352975138990517. 351813978990
555/352975138990558.351813978990605/352975138990608. 351813978990662/352975138990665. 351813978990670/352975138990673. 3518139789
90696/352975138990699. 351813978990712/352975138990715. 351813978990720/352975138990723. 351813978990738/352975138990731. 3518139
78990795/352975138990798. 351813978990811/352975138990814. 351813978990829/352975138990822. 351813978990837/352975138990830. 3518
13978990845/352975138990848. 351813978990860/352975138990863. 351813978990878/352975138990871. 351813978990886/352975138990889. 3
51813978990894/352975138990897. 351813978990936/352975138990939.351813978990944/352975138990947. 351813978990969/352975138990962.
351813978991025/352975138991028. 351813978991041/352975138991044. 351813978991140/352975138991143. 351813978991173/3529751389911
76. 351813978991231/352975138991234. 351813978991264/352975138991267. 351813978991272/352975138991275. 351813978991298/3529751389
91291. 351813978991413/352975138991416. 351813978991439/352975138991432. 351813978991447/352975138991440. 351813978991470/3529751
38991473. 351813978991488/352975138991481. 351813978991504/352975138991507. 351813978991512/352975138991515. 351813978991546/3529
75138991549. 351813978991637/352975138991630. 351813978991652/352975138991655. 351813978991660/352975138991663. 351813978991678/3
52975138991671. 351813978991686/352975138991689. 351813978991694/352975138991697. 351813978991736/352975138991739. 35181397899177
7/352975138991770. 351813978991801/352975138991804. 351813978991850/352975138991853. 351813978991876/352975138991879. 35181397899
1884/352975138991887. 351813978991918/352975138991911. 351813978991975/352975138991978. 351813978991983/352975138991986. 35181397
8992015/352975138992018. 351813978992023/352975138992026. 351813978992031/352975138992034. 351813978992072/352975138992075. 35181
3978992080/352975138992083. 351813978992098/352975138992091. 351813978992106/352975138992109. 351813978992114/352975138992117. 35
1813978992130/352975138992133. 351813978992148/352975138992141. 351813978992163/352975138992166. 351813978992247/352975138992240.
351813978992361/352975138992364. 351813978992411/352975138992414. 351813978992601/352975138992604. 351813978992635/3529751389926
38. 351813978992692/352975138992695. 351813978992734/352975138992737. 351813978992825/352975138992828. 351813978992833/3529751389
92836.351813978992882/352975138992885. 351813978992916/352975138992919. 351813978992924/352975138992927. 351813978992940/35297513
8992943. 351813978992981/352975138992984. 351813978993005/352975138993008. 351813978993039/352975138993032. 351813978993062/35297
5138993065. 351813978993088/352975138993081. 351813978993161/352975138993164. 351813978993179/352975138993172. 351813978993195/35
2975138993198. 351813978993203/352975138993206. 351813978993260/352975138993263. 351813978993310/352975138993313. 351813978993336
/352975138993339. 351813978993369/352975138993362.351813978993401/352975138993404. 351813978993419/352975138993412. 3518139789936
17/352975138993610. 351813978993674/352975138993677. 351813978993682/352975138993685. 351813978993732/352975138993735. 3518139789
93757/352975138993750. 351813978993765/352975138993768. 351813978993807/352975138993800. 351813978993815/352975138993818. 3518139
78993856/352975138993859. 351813978993906/352975138993909. 351813978993930/352975138993933. 351813978993997/352975138993990. 3518
13978994094/352975138994097. 351813978994136/352975138994139. 351813978994318/352975138994311. 351813978994342/352975138994345. 3
51813978994433/352975138994436. 351813978994490/352975138994493. 351813978994698/352975138994691. 351813978994847/352975138994840
. 351813978994854/352975138994857. 351813978994888/352975138994881. 351813978994904/352975138994907. 351813978994946/352975138994
949. 351813978994953/352975138994956. 351813978995018/352975138995011. 351813978995034/352975138995037. 351813978995141/352975138
995144. 351813978995612/352975138995615. 351813978995729/352975138995722. 351813978995752/352975138995755. 351813978995760/352975
138995763. 351813978995992/352975138995995. 351813978996644/352975138996647. 351813978996677/352975138996670. 351813978997097/352
975138997090. 351813978997279/352975138997272. 351813978997345/352975138997348. 351813978997378/352975138997371. 351813978997410/
352975138997413. 351813978997535/352975138997538. 351813978997543/352975138997546. 351813978997592/352975138997595. 3518139789976
00/352975138997603. 351813978997642/352975138997645. 351813978997659/352975138997652. 351813978997717/352975138997710. 3518139789
97733/352975138997736. 351813978997741/352975138997744. 351813978997766/352975138997769. 351813978997782/352975138997785.35181397
032025001453868-2
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001453868-2
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
8997790/352975138997793. 351813978997865/352975138997868. 351813978997873/352975138997876. 351813978997881/352975138997884. 35181
3978997931/352975138997934. 351813978997964/352975138997967. 351813978998046/352975138998049. 351813978998061/352975138998064. 35
1813978998103/352975138998106. 351813978998129/352975138998122. 351813978998137/352975138998130. 351813978998269/352975138998262.
351813978998285/352975138998288. 351813978998343/352975138998346. 351813978998350/352975138998353. 351813978998368/3529751389983
61. 351813978998400/352975138998403.351813978998475/352975138998478. 351813978998541/352975138998544. 351813978998582/35297513899
8585. 351813978998608/352975138998601. 351813978998624/352975138998627. 351813978998657/352975138998650. 351813978998699/35297513
8998692. 351813978998715/352975138998718. 351813978998772/352975138998775. 351813978998780/352975138998783. 351813978998798/35297
5138998791. 351813978998822/352975138998825. 351813978998889/352975138998882. 351813978998897/352975138998890. 351813978998947/35
2975138998940. 351813978998962/352975138998965. 351813978998970/352975138998973. 351813978999119/352975138999112. 351813978999127
/352975138999120. 351813978999135/352975138999138. 351813978999150/352975138999153. 351813978999192/352975138999195. 351813978999
234/352975138999237. 351813978999242/352975138999245. 351813978999259/352975138999252. 351813978999374/352975138999377. 351813978
999424/352975138999427. 351813978999440/352975138999443. 351813978999457/352975138999450. 351813978999473/352975138999476. 351813
978999515/352975138999518. 351813978999549/352975138999542. 351813978999564/352975138999567. 351813978999572/352975138999575. 351
813978999580/352975138999583. 351813978999648/352975138999641. 351813978999663/352975138999666. 351813978999697/352975138999690.
351813978999713/352975138999716. 351813978999721/352975138999724. 351813978999754/352975138999757. 351813978999796/35297513899979
9. 351813978999804/352975138999807. 351813978999853/352975138999856. 351813978999879/352975138999872. 351813978999903/35297513899
9906. 351813978999978/352975138999971. 351813979000065/352975139000068. 351813979000131/352975139000134. 351813979000156/35297513
9000159. 351813979000222/352975139000225. 351813979000230/352975139000233. 351813979000255/352975139000258.351813979000305/352975
139000308. 351813979000321/352975139000324. 351813979000438/352975139000431. 351813979000487/352975139000480. 351813979000529/352
975139000522. 351813979000545/352975139000548. 351813979000586/352975139000589. 351813979000628/352975139000621. 351813979000685/
352975139000688. 351813979000693/352975139000696. 351813979000701/352975139000704. 351813979000735/352975139000738. 3518139790008
59/352975139000852. 351813979000867/352975139000860. 351813979000883/352975139000886. 351813979000891/352975139000894. 3518139790
00909/352975139000902.351813979000925/352975139000928. 351813979000933/352975139000936. 351813979001048/352975139001041. 35181397
9001097/352975139001090. 351813979001204/352975139001207. 351813979001220/352975139001223. 351813979001246/352975139001249. 35181
3979001345/352975139001348. 351813979001378/352975139001371. 351813979001410/352975139001413. 351813979001444/352975139001447. 35
1813979001469/352975139001462. 351813979001493/352975139001496. 351813979001501/352975139001504. 351813979060952/352975139060955.
351813979060978/352975139060971. 351813979060986/352975139060989. 351813979061000/352975139061003. 351813979061018/3529751390610
11. 351813979061026/352975139061029. 351813979061034/352975139061037. 351813979061042/352975139061045. 351813979061067/3529751390
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032025001453868-2
Espacio para uso exclusivo de la Entidad Recaudadora
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