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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
032025001638213-4
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
Inicial
33 . Cod.
1
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. 116575016022917
43 . Año – Mes – Día
2025 – 09 – 09
44 . Documento de transporte
No. T61725H03142
45 . Año – Mes – Día
2025 – 09 – 06
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
6900387784
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.
131.00
72 . Peso neto kgs. dcms.
90.65
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
370.00
78 .Valor FOB
USD
18.234.22
79 . Valor fletes USD
989.05 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
76.724.315
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
76.724.315
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
0.63
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
989.68
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
19.223.90
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: 572314-DECL: 1952977-DO: 893122441251- 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: 3097845458. ID DELIVERY: 6084379889. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A075MLVDLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A07 LTE DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VIOLETA(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
032025001638213
133. Feha: 202509 11
134 . Levante No. 032025001378445 135 . Fecha
2025 – 09 – 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 92032507072991
Fecha presentación 2025-09-11 10:07:13
Valor pagado $0.00
Fecha de Impresión: 2025-09-11 10:07:19
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001638213-4
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
, MODELO: SM-A075M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A075M/DS,LIGHT VIOLET,LTC( QTY. 370,00 u )(37
0,00 PCE); IMEIS: 352169181395762/354282521395760. 352169181395770/354282521395778. 352169181729614/354282521729612. 352169181729
622/354282521729620. 352169181729630/354282521729638. 352169181729655/354282521729653. 352169181729663/354282521729661. 352169181
729671/354282521729679. 352169181729689/354282521729687. 352169181729697/354282521729695. 352169181729705/354282521729703. 352169
181729721/354282521729729. 352169181729739/354282521729737.352169181729747/354282521729745. 352169181729788/354282521729786. 3521
69181729796/354282521729794. 352169181729812/354282521729810. 352169181729853/354282521729851. 352169181729861/354282521729869. 3
52169181729903/354282521729901. 352169181729911/354282521729919. 352169181729937/354282521729935. 352169181729945/354282521729943
. 352169181729952/354282521729950. 352169181729960/354282521729968. 352169181729978/3542825 21729976. 352169181730000/35428252173
0008. 352169181730026/354282521730024. 352169181730034/354282521730032. 352169181730042/354282521730040. 352169181730067/35428252
1730065. 352169181730075/354282521730073. 352169181730083/354282521730081. 352169181730091/354282521730099. 352169181730109/35428
2521730107. 352169181730117/354282521730115. 352169181730133/354282521730131. 352169181730141/354282521730149. 352169181730158/35
4282521730156. 352169181730174/354282521730172. 352169181730182/354282521730180. 352169181730190/354282521730198. 352169181730208
/354282521730206. 352169181730216/354282521730214. 352169181730232/354282521730230. 352169181730240/354282521730248. 352169181730
257/354282521730255. 352169181730273/354282521730271. 352169181730281/354282521730289. 352169181730307/354282521730305. 352169181
730323/354282521730321. 352169181730331/354282521730339. 352169181730349/354282521730347. 352169181730372/354282521730370. 352169
181730380/354282521730388. 352169181730398/354282521730396. 352169181730406/354282521730404. 352169181730414/354282521730412. 352
169181730422/354282521730420. 352169181730430/354282521730438. 352169181730448/354282521730446. 352169181730455/354282521730453.
352169181730463/354282521730461. 352169181730471/354282521730479. 352169181730489/354282521730487. 352169181730497/35428252173049
5.352169181730513/354282521730511. 352169181730521/354282521730529. 352169181730539/354282521730537. 352169181730554/354282521730
552. 352169181730562/354282521730560. 352169181730570/354282521730578. 352169181730588/354282521730586. 352169181730596/354282521
730594. 352169181730604/354282521730602. 352169181730612/354282521730610. 352169181730620/354282521730628. 352169181730638/354282
521730636. 352169181730646/354282521730644. 352169181730653/354282521730651. 352169181730661/354282521730669. 352169181730679/354
282521730677. 352169181730695/354282521730693.352169181730703/354282521730701. 352169181730711/354282521730719. 352169181730729/3
54282521730727. 352169181730737/354282521730735. 352169181730745/354282521730743. 352169181730752/354282521730750. 35216918173077
8/354282521730776. 352169181730786/354282521730784. 352169181730794/354282521730792. 352169181730802/354282521730800. 35216918173
0810/354282521730818. 352169181730828/354282521730826. 352169181730836/354282521730834. 352169181730844/354282521730842. 35216918
1730851/354282521730859. 352169181730877/354282521730875. 352169181730885/354282521730883. 352169181730893/354282521730891. 35216
9181730901/354282521730909. 352169181730919/354282521730917. 352169181730927/354282521730925. 352169181730935/354282521730933. 35
2169181730943/354282521730941. 352169181730950/354282521730958. 352169181730968/354282521730966. 352169181730976/354282521730974.
352169181730984/354282521730982. 352169181730992/354282521730990. 352169181731008/354282521731006. 352169181731016/3542825217310
14. 352169181731024/354282521731022. 352169181731040/354282521731048. 352169181731065/354282521731063. 352169181731073/3542825217
31071. 352169181731081/354282521731089. 352169181731099/354282521731097. 352169181731107/354282521731105. 352169181731115/3542825
21731113. 352169181731123/354282521731121. 352169181731131/354282521731139. 352169181731156/354282521731154. 352169181731164/3542
82521731162. 352169181731172/354282521731170. 352169181731180/354282521731188. 352169181731198/354282521731196. 352169181731206/3
54282521731204. 352169181731214/354282521731212. 352169181731222/354282521731220. 352169181731248/354282521731246. 35216918173125
5/354282521731253. 352169181731263/354282521731261. 352169181731289/354282521731287. 352169181731321/354282521731329.352169181731
339/354282521731337. 352169181731347/354282521731345. 352169181731354/354282521731352. 352169181731362/354282521731360. 352169181
731370/354282521731378. 352169181731388/354282521731386. 352169181731396/354282521731394. 352169181731495/354282521731493. 352169
181731503/354282521731501. 352169181731529/354282521731527. 352169181731537/354282521731535. 352169181731552/354282521731550. 352
169181731560/354282521731568. 352169181731578/354282521731576. 352169181731586/354282521731584. 352169181731602/354282521731600.
352169181731651/354282521731659.352169181731693/354282521731691. 352169181731701/354282521731709. 352169181731719/354282521731717
. 352169181731784/354282521731782. 352169181731792/354282521731790. 352169181731800/354282521731808. 352169181731826/354282521731
824. 352169181731834/354282521731832. 352169181731842/354282521731840. 352169181731859/354282521731857. 352169181731883/354282521
731881. 352169181731933/354282521731931. 352169181731958/354282521731956. 352169181731966/354282521731964. 352169181731974/354282
521731972. 352169181731990/354282521731998. 352169181732006/354282521732004. 352169181732030/354282521732038. 352169181732048/354
282521732046. 352169181732055/354282521732053. 352169181732063/354282521732061. 352169181732121/354282521732129. 352169181732147/
354282521732145. 352169181732162/354282521732160. 352169181732188/354282521732186. 352169181732196/354282521732194. 3521691817322
04/354282521732202. 352169181732220/354282521732228. 352169181732238/354282521732236. 352169181732246/354282521732244. 3521691817
32261/354282521732269. 352169181732279/354282521732277. 352169181732287/354282521732285. 352169181732303/354282521732301. 3521691
81732311/354282521732319. 352169181732360/354282521732368. 352169181732386/354282521732384. 352169181732394/354282521732392. 3521
69181732402/354282521732400. 352169181732410/354282521732418. 352169181732428/354282521732426. 352169181732501/354282521732509. 3
52169181732519/354282521732517. 352169181732527/354282521732525. 352169181732535/354282521732533. 352169181732550/354282521732558
. 352169181732618/354282521732616. 352169181732626/354282521732624. 352169181732642/354282521732640. 352169181732659/354282521732
657. 352169181732675/354282521732673. 352169181732691/354282521732699. 352169181732709/354282521732707.352169181732725/3542825217
32723. 352169181732758/354282521732756. 352169181732766/354282521732764. 352169181732790/354282521732798. 352169181732824/3542825
21732822. 352169181732899/354282521732897. 352169181732956/354282521732954. 352169181732964/354282521732962. 352169181732972/3542
82521732970. 352169181732980/354282521732988. 352169181732998/354282521732996. 352169181733004/354282521733002. 352169181733012/3
54282521733010. 352169181733020/354282521733028. 352169181733038/354282521733036. 352169181733061/354282521733069. 35216918173307
9/354282521733077.352169181733087/354282521733085. 352169181733111/354282521733119. 352169181733129/354282521733127. 352169181733
145/354282521733143. 352169181733152/354282521733150. 352169181733186/354282521733184. 352169181733228/354282521733226. 352169181
733236/354282521733234. 352169181733269/354282521733267. 352169181733277/354282521733275. 352169181733285/354282521733283. 352169
181733293/354282521733291. 352169181733301/354282521733309. 352169181733343/354282521733341. 352169181733368/354282521733366. 352
169181733376/354282521733374. 352169181733384/354282521733382. 352169181733459/354282521733457. 352169181733475/354282521733473.
352169181733483/354282521733481. 352169181733517/354282521733515. 352169181733558/354282521733556. 352169181733566/35428252173356
4. 352169181733590/354282521733598. 352169181733616/354282521733614. 352169181733723/354282521733721. 352169181733772/35428252173
3770. 352169181733798/354282521733796. 352169181733814/354282521733812. 352169181733848/354282521733846. 352169181733871/35428252
1733879. 352169181733897/354282521733895. 352169181733905/354282521733903. 352169181733921/354282521733929. 352169181733939/35428
2521733937. 352169181733954/354282521733952. 352169181733962/354282521733960. 352169181734036/354282521734034. 352169181734077/35
4282521734075. 352169181734119/354282521734117. 352169181734127/354282521734125. 352169181734135/354282521734133. 352169181734143
/354282521734141. 352169181734150/354282521734158. 352169181734176/354282521734174. 352169181734200/354282521734208. 352169181734
218/354282521734216. 352169181734226/354282521734224. 352169181734234/354282521734232. 352169181734242/354282521734240. 352169181
734283/354282521734281. 352169181734309/354282521734307. 352169181734317/354282521734315.352169181734325/354282521734323. 3521691
81734341/354282521734349. 352169181734358/354282521734356. 352169181734408/354282521734406. 352169181734432/354282521734430. 3521
69181734473/354282521734471. 352169181734481/354282521734489. 352169181734499/354282521734497. 352169181734556/354282521734554. 3
52169181734598/354282521734596. 352169181734606/354282521734604. 352169181734614/354282521734612. 352169181734622/354282521734620
032025001638213-4
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025001638213-4
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
. 352169181734655/354282521734653. 352169181734671/354282521734679. 352169181734697/354282521734695. 352169181734762/354282521734
760.352169181734770/354282521734778. 352169181734796/354282521734794. 352169181734812/354282521734810. 352169181734820/3542825217
34828. 352169181734879/354282521734877. 352169181734887/354282521734885. 352169181734895/354282521734893. 352169181734911/3542825
21734919. 352169181734952/354282521734950. 352169181734978/354282521734976. 352169181734986/354282521734984. 352169181735009/3542
82521735007. 352169181735025/354282521735023. 352169181735033/354282521735031. 352169181735082/354282521735080. 352169181735199/3
54282521735197. 352169181735207/354282521735205. 352169181735215/354282521735213. 352169181735223/354282521735221. 35216918173523
1/354282521735239. 352169181735256/354282521735254. 352169181735272/354282521735270. 352169181735280/354282521735288. 35216918173
5298/354282521735296. 352169181735314/354282521735312. 352169181735322/354282521735320. 352169181735330/354282521735338. 35216918
1735389/354282521735387. 352169181735413/354282521735411. 352169181735421/354282521735429. 352169181735454/354282521735452. 35216
9181735520/354282521735528. 352169181735546/354282521735544. 352169181735553/354282521735551. 352169181735587/354282521735585. 35
2169181735595/354282521735593. 352169181735603/354282521735601. 352169181735629/354282521735627. 352169181735645/354282521735643.
352169181735660/354282521735668. 352169181735678/354282521735676. 352169181735686/354282521735684. 352169181735694/3542825217356
92. 352169181735702/354282521735700. 352169181735710/354282521735718. 352169181735736/354282521735734. 352169181735744/3542825217
35742. 352169181735769/354282521735767. 352169181735777/354282521735775. 352169181735868/354282521735866. 352169181735926/3542825
21735924. 352169181735934/354282521735932. 352169181736056/354282521736054.352169181736064/354282521736062. 352169181736072/35428
2521736070. 352169181736213/354282521736211. 352169181736254/354282521736252. 352169181736403/354282521736401. 352169181736429/35
4282521736427. 352169181736452/354282521736450. 352169181736528/354282521736526. 352169181736536/354282521736534. 352169181736544
/354282521736542. 352169181736627/354282521736625. 352169181736643/354282521736641. 352169181736650/354282521736658. 352169181736
718/354282521736716. 352169181736734/354282521736732. 352169181736767/354282521736765. 352169181736809/354282521736807.3521691817
36817/354282521736815. 352169181736841/354282521736849. 352169181736908/354282521736906. 352169181736916/354282521736914. 3521691
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032025001638213-4
Espacio para uso exclusivo de la Entidad Recaudadora
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