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REPÚBLICA DE COLOMBIA
Declaración de Importación Privada 500
1. Año 2026
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
032026000067353-3
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. 116575016539256
43 . Año – Mes – Día
2026 – 01 – 16
44 . Documento de transporte
No. 41N0746614
45 . Año – Mes – Día
2026 – 01 – 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 16677
50 . E-mail
010-8705-6749
51 . No. de factura
6900410116
52 . Año – Mes – Día
2026 – 01 – 08
53 . Cod. país
procedencia
351
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
169
56 . Cod. Depto
destino
0
57 . Empresa transportadora
AVIANCA – ECUADOR S.A. SUCURSAL COLOMBIA
58 . Tasa de cambio $ cvs.
3.734.67
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.
132.00
72 . Peso neto kgs. dcms.
95.55
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
390.00
78 .Valor FOB
USD
18.057.66
79 . Valor fletes USD
949.08 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
70.986.255
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
70.986.255
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
949.71
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
19.007.37
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: 587096-DECL: 1991809-DO: 893100684261- 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: 3106200367. ID DELIVERY:
6086611217. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A075MZKGLTC, PRODUCTO: TELEFONO CELULAR GALAXY A07 5G DUOS(CON ACCESORIOS PA
RA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, MODELO: SM-A075M/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y(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
032026000067353
133. Feha: 202601 15
134 . Levante No. 032026000087353 135 . Fecha
2026 – 01 – 19
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 92032604605398
Fecha presentación 2026-01-15 13:30:12
Valor pagado $0.00
Fecha de Impresión: 2026-01-19 11:24:42
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000067353-3
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
AL DETAL./ /MOBILE,SM-A075M/DS,BLACK,LTC( QTY. 390,00 u )(390,00 PCE ); IMEIS: 352169189338814/354282529338812. 352169189339309/
354282529339307. 352169189339804/354282529339802. 352169189341339/354282529341337. 352169189341768/354282529341766. 3521691893417
84/354282529341782. 352169189341941/354282529341949. 352169189341958/354282529341956. 352169189342410/354282529342418. 3521691893
42428/354282529342426. 352169189342436/354282529342434. 352169189342501/354282529342509. 352169189342543/354282529342541. 3521691
89342584/354282529342582. 352169189342592/354282529342590.352169189342618/354282529342616. 352169189342931/354282529342939. 35216
9189343020/354282529343028. 352169189343038/354282529343036. 352169189343152/354282529343150. 352169189343178/354282529343176. 35
2169189343186/354282529343184. 352169189343194/354282529343192. 352169189343442/354282529343440. 352169189343483/354282529343481.
352169189343533/354282529343531. 352169189343616/354282529343614. 352169189343657/3542825 29343655. 352169189343681/354282529343
689. 352169189343699/354282529343697. 352169189343707/354282529343705. 352169189343749/354282529343747. 352169189343764/354282529
343762. 352169189343806/354282529343804. 352169189343814/354282529343812. 352169189343830/354282529343838. 352169189343848/354282
529343846. 352169189344226/354282529344224. 352169189344234/354282529344232. 352169189344242/354282529344240. 352169189344507/354
282529344505. 352169189344515/354282529344513. 352169189344606/354282529344604. 352169189344721/354282529344729. 352169189346205/
354282529346203. 352169189346247/354282529346245. 352169189346478/354282529346476. 352169189346999/354282529346997. 3521691893470
05/354282529347003. 352169189348144/354282529348142. 352169189348334/354282529348332. 352169189348433/354282529348431. 3521691893
48631/354282529348639. 352169189349340/354282529349348. 352169189349407/354282529349405. 352169189349530/354282529349538. 3521691
89349548/354282529349546. 352169189349639/354282529349637. 352169189349746/354282529349744. 352169189349936/354282529349934. 3521
69189350066/354282529350064. 352169189350272/354282529350270. 352169189350447/354282529350445. 352169189350595/354282529350593. 3
52169189350678/354282529350676. 352169189350744/354282529350742. 352169189350967/354282529350965. 352169189351064/354282529351062
.352169189351288/354282529351286. 352169189351346/354282529351344. 352169189351718/354282529351716. 352169189351726/3542825293517
24. 352169189351775/354282529351773. 352169189352765/354282529352763. 352169189352815/354282529352813. 352169189352823/3542825293
52821. 352169189352831/354282529352839. 352169189352856/354282529352854. 352169189352864/354282529352862. 352169189352872/3542825
29352870. 352169189352880/354282529352888. 352169189352898/354282529352896. 352169189352906/354282529352904. 352169189352914/3542
82529352912. 352169189352922/354282529352920.352169189352930/354282529352938. 352169189352948/354282529352946. 352169189352955/35
4282529352953. 352169189352963/354282529352961. 352169189352971/354282529352979. 352169189353003/354282529353001. 352169189353029
/354282529353027. 352169189353037/354282529353035. 352169189353045/354282529353043. 352169189353052/354282529353050. 352169189353
060/354282529353068. 352169189353078/354282529353076. 352169189353086/354282529353084. 352169189353094/354282529353092. 352169189
353102/354282529353100. 352169189353128/354282529353126. 352169189353136/354282529353134. 352169189353144/354282529353142. 352169
189353151/354282529353159. 352169189353177/354282529353175. 352169189353185/354282529353183. 352169189353193/354282529353191. 352
169189353201/354282529353209. 352169189353219/354282529353217. 352169189353227/354282529353225. 352169189353243/354282529353241.
352169189353250/354282529353258. 352169189353268/354282529353266. 352169189353276/354282529353274. 352169189353284/35428252935328
2. 352169189353292/354282529353290. 352169189353300/354282529353308. 352169189353318/354282529353316. 352169189353326/35428252935
3324. 352169189353375/354282529353373. 352169189353383/354282529353381. 352169189353391/354282529353399. 352169189353417/35428252
9353415. 352169189353441/354282529353449. 352169189353458/354282529353456. 352169189353474/354282529353472. 352169189353938/35428
2529353936. 352169189354191/354282529354199. 352169189354209/354282529354207. 352169189354357/354282529354355. 352169189354431/35
4282529354439. 352169189354696/354282529354694. 352169189355099/354282529355097. 352169189355222/354282529355220. 352169189355230
/354282529355238. 352169189355248/354282529355246. 352169189355297/354282529355295. 352169189355438/354282529355436.3521691893556
02/354282529355600. 352169189355909/354282529355907. 352169189356022/354282529356020. 352169189356295/354282529356293. 3521691893
56519/354282529356517. 352169189356659/354282529356657. 352169189356667/354282529356665. 352169189356709/354282529356707. 3521691
89356725/354282529356723. 352169189356758/354282529356756. 352169189356766/354282529356764. 352169189356774/354282529356772. 3521
69189356782/354282529356780. 352169189356790/354282529356798. 352169189356808/354282529356806. 352169189356816/354282529356814. 3
52169189356824/354282529356822.352169189356840/354282529356848. 352169189356857/354282529356855. 352169189356907/354282529356905.
352169189356923/354282529356921. 352169189357129/354282529357127. 352169189357194/354282529357192. 352169189357251/3542825293572
59. 352169189357277/354282529357275. 352169189357285/354282529357283. 352169189357327/354282529357325. 352169189357343/3542825293
57341. 352169189357350/354282529357358. 352169189357384/354282529357382. 352169189357418/354282529357416. 352169189357426/3542825
29357424. 352169189357459/354282529357457. 352169189357467/354282529357465. 352169189357483/354282529357481. 352169189357509/3542
82529357507. 352169189357525/354282529357523. 352169189357541/354282529357549. 352169189357574/354282529357572. 352169189357582/3
54282529357580. 352169189357608/354282529357606. 352169189357624/354282529357622. 352169189357657/354282529357655. 35216918935768
1/354282529357689. 352169189357699/354282529357697. 352169189357707/354282529357705. 352169189357764/354282529357762. 35216918935
7814/354282529357812. 352169189357822/354282529357820. 352169189357830/354282529357838. 352169189357871/354282529357879. 35216918
9357897/354282529357895. 352169189357954/354282529357952. 352169189357962/354282529357960. 352169189357988/354282529357986. 35216
9189358002/354282529358000. 352169189358028/354282529358026. 352169189358036/354282529358034. 352169189358044/354282529358042. 35
2169189358051/354282529358059. 352169189358069/354282529358067. 352169189358077/354282529358075. 352169189358093/354282529358091.
352169189358127/354282529358125. 352169189358135/354282529358133. 352169189358143/354282529358141. 352169189358218/3542825293582
16. 352169189358226/354282529358224. 352169189358242/354282529358240. 352169189358275/354282529358273.352169189358283/35428252935
8281. 352169189358291/354282529358299. 352169189358317/354282529358315. 352169189358325/354282529358323. 352169189358333/35428252
9358331. 352169189358341/354282529358349. 352169189358390/354282529358398. 352169189358416/354282529358414. 352169189358440/35428
2529358448. 352169189358465/354282529358463. 352169189358507/354282529358505. 352169189358564/354282529358562. 352169189358689/35
4282529358687. 352169189358713/354282529358711. 352169189358762/354282529358760. 352169189358770/354282529358778. 352169189358796
/354282529358794.352169189358804/354282529358802. 352169189358812/354282529358810. 352169189358820/354282529358828. 3521691893588
38/354282529358836. 352169189358846/354282529358844. 352169189358853/354282529358851. 352169189358861/354282529358869. 3521691893
58887/354282529358885. 352169189358895/354282529358893. 352169189358911/354282529358919. 352169189358929/354282529358927. 3521691
89358945/354282529358943. 352169189358960/354282529358968. 352169189358986/354282529358984. 352169189359091/354282529359099. 3521
69189359109/354282529359107. 352169189359117/354282529359115. 352169189359158/354282529359156. 352169189359174/354282529359172. 3
52169189359182/354282529359180. 352169189359190/354282529359198. 352169189359315/354282529359313. 352169189359380/354282529359388
. 352169189359398/354282529359396. 352169189359406/354282529359404. 352169189359414/354282529359412. 352169189359422/354282529359
420. 352169189359430/354282529359438. 352169189359448/354282529359446. 352169189359455/354282529359453. 352169189359463/354282529
359461. 352169189359471/354282529359479. 352169189359489/354282529359487. 352169189359497/354282529359495. 352169189359505/354282
529359503. 352169189359513/354282529359511. 352169189359547/354282529359545. 352169189359604/354282529359602. 352169189359612/354
282529359610. 352169189359620/354282529359628. 352169189359638/354282529359636. 352169189359646/354282529359644. 352169189359687/
354282529359685. 352169189359695/354282529359693. 352169189359711/354282529359719. 352169189359778/354282529359776. 3521691893598
02/354282529359800. 352169189359810/354282529359818. 352169189359836/354282529359834. 352169189359844/354282529359842. 3521691893
59869/354282529359867. 352169189359901/354282529359909. 352169189359927/354282529359925.352169189359968/354282529359966. 35216918
9359976/354282529359974. 352169189359992/354282529359990. 352169189360024/354282529360022. 352169189360040/354282529360048. 35216
9189360099/354282529360097. 352169189360107/354282529360105. 352169189360115/354282529360113. 352169189360156/354282529360154. 35
2169189360164/354282529360162. 352169189360172/354282529360170. 352169189360180/354282529360188. 352169189360206/354282529360204.
032026000067353-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000067353-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
352169189360214/354282529360212. 352169189360248/354282529360246. 352169189360263/354282529360261. 352169189360271/3542825293602
79.352169189360297/354282529360295. 352169189360305/354282529360303. 352169189360313/354282529360311. 352169189360321/35428252936
0329. 352169189360339/354282529360337. 352169189360347/354282529360345. 352169189360354/354282529360352. 352169189360362/35428252
9360360. 352169189360404/354282529360402. 352169189360420/354282529360428. 352169189360438/354282529360436. 352169189360446/35428
2529360444. 352169189360453/354282529360451. 352169189360461/354282529360469. 352169189360479/354282529360477. 352169189360487/35
4282529360485. 352169189360495/354282529360493. 352169189360503/354282529360501. 352169189360511/354282529360519. 352169189360537
/354282529360535. 352169189360545/354282529360543. 352169189360552/354282529360550. 352169189360560/354282529360568. 352169189360
578/354282529360576. 352169189360586/354282529360584. 352169189360602/354282529360600. 352169189360610/354282529360618. 352169189
360628/354282529360626. 352169189360636/354282529360634. 352169189360651/354282529360659. 352169189360677/354282529360675. 352169
189360685/354282529360683. 352169189360693/354282529360691. 352169189360701/354282529360709. 352169189360719/354282529360717. 352
169189360727/354282529360725. 352169189360735/354282529360733. 352169189360743/354282529360741. 352169189360750/354282529360758.
352169189360768/354282529360766. 352169189360776/354282529360774. 352169189360784/354282529360782. 352169189360792/35428252936079
0. 352169189360800/354282529360808. 352169189360826/354282529360824. 352169189360842/354282529360840. 352169189360859/35428252936
0857. 352169189360883/354282529360881. 352169189360891/354282529360899. 352169189360917/354282529360915. 352169189360966/35428252
9360964. 352169189360974/354282529360972. 352169189360982/354282529360980.352169189360990/354282529360998. 352169189361006/354282
529361004. 352169189361063/354282529361061. 352169189361097/354282529361095. 352169189361105/354282529361103. 352169189361113/354
282529361111. 352169189361147/354282529361145. 352169189361220/354282529361228. 352169189361311/354282529361319. 352169189361469/
354282529361467. 352169189361576/354282529361574. 352169189361626/354282529361624. 352169189361691/354282529361699. 3521691893617
09/354282529361707. 352169189361725/354282529361723. 352169189361733/354282529361731. 352169189361741/354282529361749.35216918936
1758/354282529361756. 352169189361766/354282529361764. 352169189361774/354282529361772. 352169189361782/354282529361780. 35216918
9361790/354282529361798. 352169189361808/354282529361806. 352169189361816/354282529361814. 352169189361824/354282529361822. 35216
9189361832/354282529361830. 352169189361840/354282529361848. 352169189361857/354282529361855. 352169189361865/354282529361863. 35
2169189361873/354282529361871. 352169189361881/354282529361889. 352169189361899/354282529361897. 352169189361907/354282529361905.
352169189361915/354282529361913. 352169189361923/354282529361921. 352169189361931/354282529361939. 352169189361949/3542825293619
47. 352169189361964/354282529361962. 352169189361980/354282529361988. 352169189361998/354282529361996. 352169189362004/3542825293
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032026000067353-3
Espacio para uso exclusivo de la Entidad Recaudadora
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