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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
032025002060830-1
5 . Número de Identificación Tributaria (NIT)
830028931
6 . DV.
5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
13 . Dirección
VEREDA LA PUNTA AUT MEDELLIN KM 6-685 COSTADO N
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
ROJAS MATAJUDIOS CARLOS ANDRES
31 . Clase
Importador
02
32 . Tipo declaración
Corrección
33 . Cod.
4
34 .No.Formulario Anterior
032025002033991
35 . Año – Mes – Día
2025 – 11 – 21
36 . Cod. Admón.
03
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
13907
42 . Manifiesto de carga
No. 9194651059
43 . Año – Mes – Día
2025 – 11 – 25
44 . Documento de transporte
No. PVG71644245
45 . Año – Mes – Día
2025 – 11 – 13
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 1667
50 . E-mail
010-8705-6749
51 . No. de factura
6900400928
52 . Año – Mes – Día
2025 – 11 – 11
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.
3.719.60
S59 . Subpartida arancelaria
8471300000
60 . Cod.
Complementario
XX
61 . Cod.
Suplementario
XX
62 . Cod. Modalidad
C234
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.
352.00
72 . Peso neto kgs. dcms.
300.30
73 . Código
embalaje
YY
74 . No.
bultos
2
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
660.00
78 .Valor FOB USD
46.706.37
79 . Valor fletes USD
2.604.80 Concepto % Base Total Liquidado ($)
Total a pagar con esta
declaración ($)
Total Liquidado
(USD)
Arancel
92
0.00
93
183.423.891
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
183.423.891
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
1.63
81 . Valor Otros Gastos USD
0
82 . Sumatoria de fletes, seguros
y otros gastos USD
2.606.43
83 . Ajuste valor USD
0.00
84 . Valor aduana USD
49.312.80
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: 581578-DECL: 1975762-DO: 893128865251- 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). //NO REQUIERE CERTIFICADO DE HOMOLOGACIÓN YA QUE SON DE TIPO
WI-FI// NOS ACOGEMOS: AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO DE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA
S.A. OEA COD. OE0001. . PEDIDOS:3103035642. ID DELIVERY: 6085729308. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-X133NZAECOO, PRODUCT
O: TABLET GALAXY TAB A11 WI/FI (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: GRIS, MODELO: SM-X133N,USO O DESTINO: PA
RA LA VENTA AL MAYOR Y AL DETAL./ /TABLET,SM-X133,GRAY,COO( QTY. 660,00 u )(660,00 PCE ); SERIALES:R8YYB073(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
032025002060830
133. Feha: 2025 11 26
134 . Levante No. 032025001771223 135 . Fecha
2025 – 11 – 26
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
996 . Espacio para autoadhesivo de la entidad recaudadora
(Número del adhesivo)
SYGA
Autoadhesivo 92032509356938
Fecha presentación 2025-11-26 11:22:03
Valor pagado $No se aplicó el pago
980 . Pago Total $
0
Fecha de Impresión: 2025-11-26 12:52:17
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032025002060830-1
Subpartida : 8471300000
Página 1 de 1
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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3SF. R8YYB0743TB. R8YYB0743VE. R8YYB0743XN. R8YYB0743YL. R8YYB07441P. R8YYB07444J. R8YYB07446H. R8YYB0744NA. R8YYB0745RA. R8YYB07
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074BEE. R8YYB074BLD.R8YYB074BMW. R8YYB074BQA. R8YYB074BSY. R8YYB074BTH. R8YYB074C2X. R8YYB074C9J. R8YYB074CBH. R8YYB074CCZ. R8YYB
074CDR. R8YYB074CEK. R8YYB074CFF. R8YYB074CGB. R8YYB074CHE. R8YYB074CJT. R8YYB074CKN. R8YYB074CLL. R8YYB074CMX. R8YYB074CNV. R8YY
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F. R8YYB074G9B. R8YYB074GAE. R8YYB074GBT. R8YYB074GCN. R8YYB074GDL. R8YYB074GEX. R8YYB074GFV. R8YYB074GGD. R8YYB074GHW. R8YYB074G
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032025002060830-1
Espacio para uso exclusivo de la Entidad Recaudadora
