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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
032025001633581-7
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. 116575016029265
43 . Año – Mes – Día
2025 – 09 – 11
44 . Documento de transporte
No. PVG71620358
45 . Año – Mes – Día
2025 – 09 – 04
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
6900388902
52 . Año – Mes – Día
2025 – 09 – 01
53 . Cod. país
procedencia
215
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.
3.991.09
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.
148.00
72 . Peso neto kgs. dcms.
121.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
440.00
78 .Valor FOB
USD
25.051.71
79 . Valor fletes USD
1.114.44 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
104.434.892
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
104.434.892
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
0.86
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.115.30
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
26.167.01
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: 572238-DECL: 1952888-DO: 893122419251- 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. (ANEXAMOS CERTIFICADO DE HOMOLOGACIÓN)/ NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANC
IA QUE NO REQUIERE REGISTRO DEIMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . PEDIDOS: 3097845666. ID DELIVERY:
6084388128. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A065MLBGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A06 DUOS (CON ACCESORIOS PARA
USO Y NORMAL FUNCIONAMIENTO), COLOR: AZUL CLARO, MODELO: SM-A065M/DS, USO O DESTINO: PARA LA VENTA AL MAYO(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
032025001633581
133. Feha: 202509 10
134 . Levante No. 032025001387971 135 . Fecha
2025 – 09 – 12
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 92032507048331
Fecha presentación 2025-09-10 13:21:27
Valor pagado $0.00
Fecha de Impresión: 2025-09-12 13:01:13
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001633581-7
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
R Y AL DETAL/ /MOBILE,SM-A065M/DS,LIGHT BLUE,LTC( QTY. 440,00 u )(440,00 PCE); IMEIS:355397370480056/359833790480058. 35539737048
0171/359833790480173. 355397370480197/359833790480199. 355397370480205/359833790480207. 355397370480213/359833790480215. 35539737
0480221/359833790480223. 355397370480239/359833790480231. 355397370480247/359833790480249. 355397370480254/359833790480256. 35539
7370480262/359833790480264. 355397370480270/359833790480272. 355397370480288/359833790480280. 355397370480296/359833790480298. 35
5397370480304/359833790480306. 355397370480312/359833790480314. 355397370480320/359833790480322. 355397370480338/359833790480330.
355397370480478/359833790480470. 355397370480486/359833790480488. 355397370480494/359833790480496. 355397370480502/3598337904805
04. 355397370480510/359833790480512. 355397370480528/359833790480520. 355397370480536/359833790480538. 355397370480544/3598337904
80546. 355397370480551/359833790480553. 355397370480569/359833790480561. 355397370480585/35 9833790480587. 355397370480593/359833
790480595. 355397370480601/359833790480603. 355397370480619/359833790480611. 355397370480627/359833790480629. 355397370480635/359
833790480637. 355397370480643/359833790480645. 355397370480650/359833790480652. 355397370480668/359833790480660. 355397370480676/
359833790480678. 355397370480684/359833790480686. 355397370480692/359833790480694. 355397370480700/359833790480702. 3553973704807
18/359833790480710. 355397370480726/359833790480728. 355397370480734/359833790480736. 355397370480742/359833790480744. 3553973704
80759/359833790480751. 355397370480767/359833790480769. 355397370480791/359833790480793. 355397370480825/359833790480827. 3553973
70480874/359833790480876. 355397370480882/359833790480884. 355397370480908/359833790480900. 355397370480924/359833790480926. 3553
97370480932/359833790480934.355397370480981/359833790480983. 355397370481013/359833790481015. 355397370481039/359833790481031. 35
5397370481054/359833790481056. 355397370481062/359833790481064. 355397370481096/359833790481098. 355397370481104/359833790481106.
355397370481112/359833790481114. 355397370481120/359833790481122. 355397370481138/359833790481130. 355397370481161/3598337904811
63. 355397370481203/359833790481205. 355397370481229/359833790481221. 355397370481302/359833790481304. 355397370481328/3598337904
81320. 355397370481336/359833790481338. 355397370481377/359833790481379.355397370481385/359833790481387. 355397370481450/35983379
0481452. 355397370481468/359833790481460. 355397370481500/359833790481502. 355397370481518/359833790481510. 355397370481526/35983
3790481528. 355397370481534/359833790481536. 355397370481542/359833790481544. 355397370481559/359833790481551. 355397370481567/35
9833790481569. 355397370481575/359833790481577. 355397370481583/359833790481585. 355397370481591/359833790481593. 355397370481617
/359833790481619. 355397370481625/359833790481627. 355397370481682/359833790481684. 355397370481690/359833790481692. 355397370481
708/359833790481700. 355397370481724/359833790481726. 355397370481757/359833790481759. 355397370481765/359833790481767. 355397370
481773/359833790481775. 355397370481799/359833790481791. 355397370481807/359833790481809. 355397370481815/359833790481817. 355397
370481831/359833790481833. 355397370481849/359833790481841. 355397370481906/359833790481908. 355397370482003/359833790482005. 355
397370482052/359833790482054. 355397370482128/359833790482120. 355397370482151/359833790482153. 355397370482201/359833790482203.
355397370482250/359833790482252. 355397370482268/359833790482260. 355397370482292/359833790482294. 355397370482334/35983379048233
6. 355397370482375/359833790482377. 355397370482391/359833790482393. 355397370482409/359833790482401. 355397370482417/35983379048
2419. 355397370482425/359833790482427. 355397370482441/359833790482443. 355397370482458/359833790482450. 355397370482474/35983379
0482476. 355397370482482/359833790482484. 355397370482490/359833790482492. 355397370482516/359833790482518. 355397370482524/35983
3790482526. 355397370482557/359833790482559. 355397370482565/359833790482567. 355397370482599/359833790482591. 355397370482607/35
9833790482609.355397370482623/359833790482625. 355397370482649/359833790482641. 355397370482656/359833790482658. 355397370482664/
359833790482666. 355397370482680/359833790482682. 355397370482698/359833790482690. 355397370482706/359833790482708. 3553973704827
22/359833790482724. 355397370482730/359833790482732. 355397370482748/359833790482740. 355397370482755/359833790482757. 3553973704
82763/359833790482765. 355397370482771/359833790482773. 355397370482789/359833790482781. 355397370482797/359833790482799. 3553973
70482805/359833790482807. 355397370482813/359833790482815.355397370482821/359833790482823. 355397370482839/359833790482831. 35539
7370482847/359833790482849. 355397370482870/359833790482872. 355397370482896/359833790482898. 355397370482904/359833790482906. 35
5397370482920/359833790482922. 355397370482938/359833790482930. 355397370482946/359833790482948. 355397370482953/359833790482955.
355397370482961/359833790482963. 355397370482979/359833790482971. 355397370482987/359833790482989. 355397370482995/3598337904829
97. 355397370483001/359833790483003. 355397370483027/359833790483029. 355397370483035/359833790483037. 355397370483043/3598337904
83045. 355397370483050/359833790483052. 355397370483068/359833790483060. 355397370483076/359833790483078. 355397370483084/3598337
90483086. 355397370483092/359833790483094. 355397370483100/359833790483102. 355397370483118/359833790483110. 355397370483126/3598
33790483128. 355397370483134/359833790483136. 355397370483142/359833790483144. 355397370483159/359833790483151. 355397370483167/3
59833790483169. 355397370483183/359833790483185. 355397370483191/359833790483193. 355397370483209/359833790483201. 35539737048321
7/359833790483219. 355397370483225/359833790483227. 355397370483258/359833790483250. 355397370483266/359833790483268. 35539737048
3290/359833790483292. 355397370483308/359833790483300. 355397370483316/359833790483318. 355397370483324/359833790483326. 35539737
0483332/359833790483334. 355397370483357/359833790483359. 355397370483373/359833790483375. 355397370483381/359833790483383. 35539
7370483399/359833790483391. 355397370483407/359833790483409. 355397370483415/359833790483417. 355397370483431/359833790483433. 35
5397370483449/359833790483441. 355397370483464/359833790483466. 355397370483480/359833790483482. 355397370483506/359833790483508.
355397370483514/359833790483516. 355397370483548/359833790483540. 355397370483563/359833790483565. 355397370483571/35983379048357
3. 355397370483621/359833790483623. 355397370483639/359833790483631. 355397370483647/359833790483649. 355397370483654/35983379048
3656. 355397370483662/359833790483664. 355397370483670/359833790483672. 355397370484272/359833790484274. 355397370484827/35983379
0484829. 355397370484918/359833790484910. 355397370484959/359833790484951. 355397370484967/359833790484969. 355397370485055/35983
3790485057. 355397370485063/359833790485065.355397370485071/359833790485073. 355397370485089/359833790485081. 355397370485113/359
833790485115. 355397370485121/359833790485123. 355397370485139/359833790485131. 355397370485147/359833790485149. 355397370485154/
359833790485156. 355397370485162/359833790485164. 355397370485196/359833790485198. 355397370485220/359833790485222. 3553973704852
53/359833790485255. 355397370485261/359833790485263. 355397370485295/359833790485297. 355397370485303/359833790485305. 3553973704
85311/359833790485313. 355397370485329/359833790485321. 355397370485337/359833790485339. 355397370485360/359833790485362. 3553973
70485378/359833790485370. 355397370485386/359833790485388. 355397370485394/359833790485396. 355397370485402/359833790485404. 3553
97370485410/359833790485412. 355397370485436/359833790485438. 355397370485444/359833790485446. 355397370485477/359833790485479. 3
55397370485535/359833790485537. 355397370485568/359833790485560. 355397370485576/359833790485578. 355397370485592/359833790485594
. 355397370485626/359833790485628. 355397370485659/359833790485651. 355397370485725/359833790485727. 355397370485733/359833790485
735. 355397370485758/359833790485750. 355397370485766/359833790485768. 355397370485774/359833790485776. 355397370485782/359833790
485784. 355397370485790/359833790485792. 355397370485808/359833790485800. 355397370485816/359833790485818. 355397370485824/359833
790485826. 355397370485832/359833790485834. 355397370485840/359833790485842. 355397370485857/359833790485859. 355397370485865/359
833790485867. 355397370485873/359833790485875. 355397370485881/359833790485883. 355397370485899/359833790485891. 355397370485907/
359833790485909. 355397370485915/359833790485917. 355397370485931/359833790485933. 355397370485949/359833790485941.35539737048595
6/359833790485958. 355397370485964/359833790485966. 355397370485972/359833790485974. 355397370485980/359833790485982. 35539737048
5998/359833790485990. 355397370486004/359833790486006. 355397370486012/359833790486014. 355397370486020/359833790486022. 35539737
0486038/359833790486030. 355397370486046/359833790486048. 355397370486053/359833790486055. 355397370486061/359833790486063. 35539
7370486079/359833790486071. 355397370486087/359833790486089. 355397370486095/359833790486097. 355397370486103/359833790486105. 35
5397370486111/359833790486113.355397370486129/359833790486121. 355397370486137/359833790486139. 355397370486145/359833790486147.
355397370486152/359833790486154. 355397370486178/359833790486170. 355397370486186/359833790486188. 355397370486194/35983379048619
6. 355397370486202/359833790486204. 355397370486210/359833790486212. 355397370486228/359833790486220. 355397370486236/35983379048
032025001633581-7
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001633581-7
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
6238. 355397370486244/359833790486246. 355397370486251/359833790486253. 355397370486269/359833790486261. 355397370486277/35983379
0486279. 355397370486285/359833790486287. 355397370486293/359833790486295. 355397370486301/359833790486303. 355397370486319/35983
3790486311. 355397370486327/359833790486329. 355397370486335/359833790486337. 355397370486343/359833790486345. 355397370486368/35
9833790486360. 355397370486376/359833790486378. 355397370486384/359833790486386. 355397370486392/359833790486394. 355397370486400
/359833790486402. 355397370486418/359833790486410. 355397370486426/359833790486428. 355397370486434/359833790486436. 355397370486
442/359833790486444. 355397370486459/359833790486451. 355397370486467/359833790486469. 355397370486475/359833790486477. 355397370
486483/359833790486485. 355397370486509/359833790486501. 355397370486517/359833790486519. 355397370486525/359833790486527. 355397
370486541/359833790486543. 355397370486558/359833790486550. 355397370486566/359833790486568. 355397370486574/359833790486576. 355
397370486582/359833790486584. 355397370486590/359833790486592. 355397370486608/359833790486600. 355397370486616/359833790486618.
355397370486624/359833790486626. 355397370486632/359833790486634. 355397370486640/359833790486642. 355397370486657/35983379048665
9. 355397370486665/359833790486667. 355397370486673/359833790486675. 355397370486681/359833790486683.355397370486699/359833790486
691. 355397370486707/359833790486709. 355397370486715/359833790486717. 355397370486723/359833790486725. 355397370486731/359833790
486733. 355397370486749/359833790486741. 355397370486756/359833790486758. 355397370486764/359833790486766. 355397370486772/359833
790486774. 355397370486780/359833790486782. 355397370486798/359833790486790. 355397370486806/359833790486808. 355397370486814/359
833790486816. 355397370486822/359833790486824. 355397370486830/359833790486832. 355397370486848/359833790486840. 355397370486855/
359833790486857.355397370486863/359833790486865. 355397370486871/359833790486873. 355397370486889/359833790486881. 35539737048689
7/359833790486899. 355397370486905/359833790486907. 355397370486913/359833790486915. 355397370486921/359833790486923. 35539737048
6939/359833790486931. 355397370486947/359833790486949. 355397370486954/359833790486956. 355397370486962/359833790486964. 35539737
0486970/359833790486972. 355397370486988/359833790486980. 355397370486996/359833790486998. 355397370487002/359833790487004. 35539
7370487010/359833790487012. 355397370487028/359833790487020. 355397370487036/359833790487038. 355397370487044/359833790487046. 35
5397370487051/359833790487053. 355397370487069/359833790487061. 355397370487085/359833790487087. 355397370487093/359833790487095.
355397370487101/359833790487103. 355397370487119/359833790487111. 355397370487127/359833790487129. 355397370487135/3598337904871
37. 355397370487143/359833790487145. 355397370487168/359833790487160. 355397370487176/359833790487178. 355397370487184/3598337904
87186. 355397370487192/359833790487194. 355397370487218/359833790487210. 355397370487226/359833790487228. 355397370487234/3598337
90487236. 355397370487242/359833790487244. 355397370487275/359833790487277. 355397370487283/359833790487285. 355397370487291/3598
33790487293. 355397370487309/359833790487301. 355397370487317/359833790487319. 355397370487333/359833790487335. 355397370487341/3
59833790487343. 355397370487358/359833790487350. 355397370487382/359833790487384. 355397370487390/359833790487392. 35539737048742
4/359833790487426. 355397370487432/359833790487434. 355397370487457/359833790487459. 355397370487465/359833790487467. 35539737048
7473/359833790487475. 355397370487481/359833790487483. 355397370487523/359833790487525.355397370487531/359833790487533. 355397370
487572/359833790487574. 355397370487614/359833790487616. 355397370487622/359833790487624. 355397370487630/359833790487632. 355397
370487671/359833790487673. 355397370487796/359833790487798. 355397370487812/359833790487814. 355397370487820/359833790487822. 355
397370487838/359833790487830. 355397370487846/359833790487848. 355397370487853/359833790487855. 355397370487861/359833790487863.
355397370487895/359833790487897. 355397370487911/359833790487913. 355397370487937/359833790487939. 355397370487945/35983379048794
7.355397370487952/359833790487954. 355397370487960/359833790487962. 355397370487978/359833790487970. 355397370487994/359833790487
996. 355397370488018/359833790488010. 355397370488042/359833790488044. 355397370488067/359833790488069. 355397370488075/359833790
488077. 355397370488125/359833790488127. 355397370488133/359833790488135. 355397370488141/359833790488143. 355397370488158/359833
790488150. 355397370488166/359833790488168. 355397370488174/359833790488176. 355397370488224/359833790488226. 355397370488232/359
833790488234. 355397370488240/359833790488242. 355397370488257/359833790488259. 355397370488356/359833790488358. 355397370488398/
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032025001633581-7
Espacio para uso exclusivo de la Entidad Recaudadora
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