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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
032026000378540-9
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. 116575016792807
43 . Año – Mes – Día
2026 – 03 – 12
44 . Documento de transporte
No. SHAN0471992
45 . Año – Mes – Día
2026 – 03 – 07
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
9104194995
52 . Año – Mes – Día
2026 – 03 – 07
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.
3.767.94
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.
185.50
72 . Peso neto kgs. dcms.
140.00
73 . Código
embalaje
YY
74 . No. bultos
1
75 . Subpartidas
1
76 . Cod. unidad
comercial
U
77 . Cantidad dcms.
500.00
78 .Valor FOB
USD
112.524.17
79 . Valor fletes USD
1.508.12 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
429.680.994
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
429.680.994
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
3.76
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.511.88
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
114.036.05
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: 593646-DECL: 2009547-DO: 893105817261- 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: 3110498067. ID DELIVERY:
6087476988. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A376BZAKLTC, PRODUCTO: TELEFONO CELULAR GALAXY A37 5G DUOS(CON ACCESORIOS PA
RA USO Y NORMAL FUNCIONAMIENTO), COLOR: GRIS,MODELO: SM-A376B/DS,USO O DESTINO: PARA LA VENTA AL MAYOR Y AL(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
032026000378540
133. Feha: 202603 11
134 . Levante No. 032026000358565 135 . Fecha
2026 – 03 – 13
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 92032606185990
Fecha presentación 2026-03-11 14:26:12
Valor pagado $0.00
Fecha de Impresión: 2026-03-13 13:05:13
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000378540-9
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
DETAL./ /MOBILE,SM-A376B/DS,GRAY,LTC( QTY. 500,00 u )(500,00 PCE ); IMEIS: 356599700359228/356975820359225. 356599700359319/3569
75820359316. 356599700359590/356975820359597. 356599700359798/356975820359795. 356599700359863/356975820359860. 356599700359905/3
56975820359902. 356599700359970/356975820359977. 356599700360051/356975820360058. 356599700360077/356975820360074. 35659970036009
3/356975820360090. 356599700360127/356975820360124. 356599700360143/356975820360140. 356599700360150/356975820360157.356599700360
176/356975820360173. 356599700360184/356975820360181. 356599700360200/356975820360207. 356599700360218/356975820360215. 356599700
360226/356975820360223. 356599700360234/356975820360231. 356599700360267/356975820360264. 356599700360291/356975820360298. 356599
700360309/356975820360306. 356599700360325/356975820360322. 356599700360374/356975820360371. 356599700360408/356975820360405. 356
599700360416/356975820360413. 356599700360432/356975820360439. 356599700360440/35697582036 0447. 356599700360457/356975820360454.
356599700360499/356975820360496. 356599700360507/356975820360504. 356599700360515/356975820360512. 356599700360523/3569758203605
20. 356599700360531/356975820360538. 356599700360598/356975820360595. 356599700361141/356975820361148. 356599700362198/3569758203
62195. 356599700362222/356975820362229. 356599700364137/356975820364134. 356599700364210/356975820364217. 356599700364343/3569758
20364340. 356599700364749/356975820364746. 356599700364921/356975820364928. 356599700365092/356975820365099. 356599700365308/3569
75820365305. 356599700365498/356975820365495. 356599700365506/356975820365503. 356599700365530/356975820365537. 356599700365555/3
56975820365552. 356599700365563/356975820365560. 356599700365571/356975820365578. 356599700365597/356975820365594. 35659970036560
5/356975820365602. 356599700365613/356975820365610. 356599700365639/356975820365636. 356599700365647/356975820365644. 35659970036
5654/356975820365651. 356599700365662/356975820365669. 356599700365670/356975820365677. 356599700365688/356975820365685. 35659970
0365696/356975820365693. 356599700365704/356975820365701. 356599700365712/356975820365719. 356599700365738/356975820365735. 35659
9700365746/356975820365743. 356599700365753/356975820365750.356599700365779/356975820365776. 356599700365787/356975820365784. 356
599700365795/356975820365792. 356599700365803/356975820365800. 356599700365811/356975820365818. 356599700365829/356975820365826.
356599700365837/356975820365834. 356599700365845/356975820365842. 356599700365852/356975820365859. 356599700365860/35697582036586
7. 356599700365878/356975820365875. 356599700365886/356975820365883. 356599700365894/356975820365891. 356599700365902/35697582036
5909. 356599700365910/356975820365917. 356599700365928/356975820365925. 356599700365936/356975820365933.356599700365977/356975820
365974. 356599700365985/356975820365982. 356599700365993/356975820365990. 356599700366017/356975820366014. 356599700366025/356975
820366022. 356599700366033/356975820366030. 356599700366041/356975820366048. 356599700366058/356975820366055. 356599700366074/356
975820366071. 356599700366082/356975820366089. 356599700366090/356975820366097. 356599700366108/356975820366105. 356599700366116/
356975820366113. 356599700366124/356975820366121. 356599700366132/356975820366139. 356599700366140/356975820366147. 3565997003661
57/356975820366154. 356599700366165/356975820366162. 356599700366173/356975820366170. 356599700366181/356975820366188. 3565997003
66223/356975820366220. 356599700366249/356975820366246. 356599700366256/356975820366253. 356599700366264/356975820366261. 3565997
00366272/356975820366279. 356599700366280/356975820366287. 356599700366835/356975820366832. 356599700366868/356975820366865. 3565
99700368583/356975820368580. 356599700370480/356975820370487. 356599700370548/356975820370545. 356599700370662/356975820370669. 3
56599700370688/356975820370685. 356599700370704/356975820370701. 356599700370720/356975820370727. 356599700370787/356975820370784
. 356599700370795/356975820370792. 356599700370837/356975820370834. 356599700371256/356975820371253. 356599700371298/356975820371
295. 356599700371454/356975820371451. 356599700372130/356975820372137. 356599700373179/356975820373176. 356599700373377/356975820
373374. 356599700373500/356975820373507. 356599700373534/356975820373531. 356599700373898/356975820373895. 356599700374417/356975
820374414. 356599700374425/356975820374422. 356599700374433/356975820374430. 356599700374441/356975820374448. 356599700374458/356
975820374455. 356599700374466/356975820374463.356599700374474/356975820374471. 356599700374482/356975820374489. 356599700374508/3
56975820374505. 356599700374516/356975820374513. 356599700374532/356975820374539. 356599700374540/356975820374547. 35659970037457
3/356975820374570. 356599700374599/356975820374596. 356599700374607/356975820374604. 356599700374615/356975820374612. 35659970037
4631/356975820374638. 356599700374680/356975820374687. 356599700374698/356975820374695. 356599700374706/356975820374703. 35659970
0374722/356975820374729. 356599700374730/356975820374737. 356599700374748/356975820374745.356599700374763/356975820374760. 356599
700374771/356975820374778. 356599700374789/356975820374786. 356599700374797/356975820374794. 356599700374805/356975820374802. 356
599700374813/356975820374810. 356599700374821/356975820374828. 356599700374839/356975820374836. 356599700374847/356975820374844.
356599700374854/356975820374851. 356599700374870/356975820374877. 356599700374888/356975820374885. 356599700374896/35697582037489
3. 356599700374904/356975820374901. 356599700374912/356975820374919. 356599700374920/356975820374927. 356599700374938/35697582037
4935. 356599700374953/356975820374950. 356599700374961/356975820374968. 356599700374979/356975820374976. 356599700375000/35697582
0375007. 356599700375034/356975820375031. 356599700375067/356975820375064. 356599700375109/356975820375106. 356599700375125/35697
5820375122. 356599700375141/356975820375148. 356599700375190/356975820375197. 356599700375208/356975820375205. 356599700375216/35
6975820375213. 356599700375232/356975820375239. 356599700375257/356975820375254. 356599700375265/356975820375262. 356599700375281
/356975820375288. 356599700375315/356975820375312. 356599700375323/356975820375320. 356599700375331/356975820375338. 356599700375
349/356975820375346. 356599700375364/356975820375361. 356599700375372/356975820375379. 356599700375380/356975820375387. 356599700
375406/356975820375403. 356599700375414/356975820375411. 356599700375422/356975820375429. 356599700375430/356975820375437. 356599
700375448/356975820375445. 356599700375463/356975820375460. 356599700375489/356975820375486. 356599700375539/356975820375536. 356
599700375554/356975820375551. 356599700375562/356975820375569. 356599700375570/356975820375577. 356599700375588/356975820375585.
356599700375604/356975820375601.356599700375612/356975820375619. 356599700375620/356975820375627. 356599700375638/356975820375635
. 356599700375695/356975820375692. 356599700375703/356975820375700. 356599700375711/356975820375718. 356599700375729/356975820375
726. 356599700375737/356975820375734. 356599700375745/356975820375742. 356599700375752/356975820375759. 356599700375760/356975820
375767. 356599700375786/356975820375783. 356599700375869/356975820375866. 356599700376081/356975820376088. 356599700376131/356975
820376138. 356599700376222/356975820376229. 356599700376297/356975820376294.356599700376305/356975820376302. 356599700376370/3569
75820376377. 356599700376511/356975820376518. 356599700376537/356975820376534. 356599700376545/356975820376542. 356599700376552/3
56975820376559. 356599700376560/356975820376567. 356599700376578/356975820376575. 356599700376586/356975820376583. 35659970037659
4/356975820376591. 356599700376602/356975820376609. 356599700376610/356975820376617. 356599700376628/356975820376625. 35659970037
6636/356975820376633. 356599700376644/356975820376641. 356599700376651/356975820376658. 356599700376669/356975820376666. 35659970
0376677/356975820376674. 356599700376685/356975820376682. 356599700376693/356975820376690. 356599700376719/356975820376716. 35659
9700376727/356975820376724. 356599700376735/356975820376732. 356599700376743/356975820376740. 356599700376750/356975820376757. 35
6599700376768/356975820376765. 356599700376776/356975820376773. 356599700376784/356975820376781. 356599700376792/356975820376799.
356599700376800/356975820376807. 356599700376818/356975820376815. 356599700376826/356975820376823. 356599700376834/3569758203768
31. 356599700376842/356975820376849. 356599700376859/356975820376856. 356599700376867/356975820376864. 356599700376875/3569758203
76872. 356599700376883/356975820376880. 356599700376891/356975820376898. 356599700376909/356975820376906. 356599700376917/3569758
20376914. 356599700376925/356975820376922. 356599700376933/356975820376930. 356599700376941/356975820376948. 356599700376958/3569
75820376955. 356599700376966/356975820376963. 356599700376974/356975820376971. 356599700376982/356975820376989. 356599700376990/3
56975820376997. 356599700377006/356975820377003. 356599700377014/356975820377011. 356599700377022/356975820377029. 35659970037703
0/356975820377037.356599700377048/356975820377045. 356599700377063/356975820377060. 356599700377071/356975820377078. 356599700377
089/356975820377086. 356599700377097/356975820377094. 356599700377105/356975820377102. 356599700377113/356975820377110. 356599700
377139/356975820377136. 356599700377147/356975820377144. 356599700377154/356975820377151. 356599700377162/356975820377169. 356599
700377188/356975820377185. 356599700377196/356975820377193. 356599700377204/356975820377201. 356599700377212/356975820377219. 356
032026000378540-9
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000378540-9
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
599700377220/356975820377227. 356599700377238/356975820377235.356599700377246/356975820377243. 356599700377253/356975820377250. 3
56599700377261/356975820377268. 356599700377279/356975820377276. 356599700377287/356975820377284. 356599700377303/356975820377300
. 356599700377311/356975820377318. 356599700377329/356975820377326. 356599700377337/356975820377334. 356599700377345/356975820377
342. 356599700377352/356975820377359. 356599700377360/356975820377367. 356599700377378/356975820377375. 356599700377386/356975820
377383. 356599700377402/356975820377409. 356599700377410/356975820377417. 356599700377428/356975820377425. 356599700377451/356975
820377458. 356599700377469/356975820377466. 356599700377477/356975820377474. 356599700377485/356975820377482. 356599700377493/356
975820377490. 356599700377501/356975820377508. 356599700377519/356975820377516. 356599700377527/356975820377524. 356599700377535/
356975820377532. 356599700377543/356975820377540. 356599700377550/356975820377557. 356599700377568/356975820377565. 3565997003775
76/356975820377573. 356599700377584/356975820377581. 356599700377592/356975820377599. 356599700377600/356975820377607. 3565997003
77618/356975820377615. 356599700377626/356975820377623. 356599700377634/356975820377631. 356599700377642/356975820377649. 3565997
00377659/356975820377656. 356599700377667/356975820377664. 356599700377725/356975820377722. 356599700377733/356975820377730. 3565
99700377741/356975820377748. 356599700377758/356975820377755. 356599700377766/356975820377763. 356599700377790/356975820377797. 3
56599700377808/356975820377805. 356599700377824/356975820377821. 356599700377832/356975820377839. 356599700377840/356975820377847
. 356599700377857/356975820377854. 356599700377865/356975820377862. 356599700377873/356975820377870. 356599700377881/356975820377
888.356599700377899/356975820377896. 356599700377907/356975820377904. 356599700377915/356975820377912. 356599700377923/3569758203
77920. 356599700377931/356975820377938. 356599700377949/356975820377946. 356599700377956/356975820377953. 356599700377964/3569758
20377961. 356599700377980/356975820377987. 356599700378012/356975820378019. 356599700378020/356975820378027. 356599700378038/3569
75820378035. 356599700378046/356975820378043. 356599700378053/356975820378050. 356599700378061/356975820378068. 356599700378079/3
56975820378076. 356599700378087/356975820378084.356599700378095/356975820378092. 356599700378103/356975820378100. 356599700378111
/356975820378118. 356599700378129/356975820378126. 356599700378145/356975820378142. 356599700378152/356975820378159. 356599700378
160/356975820378167. 356599700378178/356975820378175. 356599700378186/356975820378183. 356599700378194/356975820378191. 356599700
378210/356975820378217. 356599700378228/356975820378225. 356599700378236/356975820378233. 356599700378244/356975820378241. 356599
700378251/356975820378258. 356599700378269/356975820378266. 356599700378277/356975820378274. 356599700378285/356975820378282. 356
599700378293/356975820378290. 356599700378319/356975820378316. 356599700378327/356975820378324. 356599700378335/356975820378332.
356599700378459/356975820378456. 356599700378467/356975820378464. 356599700378475/356975820378472. 356599700378483/35697582037848
0. 356599700378491/356975820378498. 356599700378509/356975820378506. 356599700378525/356975820378522. 356599700378533/35697582037
8530. 356599700378541/356975820378548. 356599700378558/356975820378555. 356599700378566/356975820378563. 356599700378574/35697582
0378571. 356599700378582/356975820378589. 356599700378590/356975820378597. 356599700378608/356975820378605. 356599700378616/35697
5820378613. 356599700378624/356975820378621. 356599700378632/356975820378639. 356599700378640/356975820378647. 356599700378657/35
6975820378654. 356599700378665/356975820378662. 356599700378673/356975820378670. 356599700378681/356975820378688. 356599700378699
/356975820378696. 356599700378707/356975820378704. 356599700378715/356975820378712. 356599700378723/356975820378720. 356599700378
731/356975820378738. 356599700378749/356975820378746. 356599700378756/356975820378753. 356599700378764/356975820378761.3565997003
78798/356975820378795. 356599700378806/356975820378803. 356599700378814/356975820378811. 356599700378822/356975820378829. 3565997
00378848/356975820378845. 356599700378855/356975820378852. 356599700378863/356975820378860. 356599700378889/356975820378886. 3565
99700378897/356975820378894. 356599700378905/356975820378902. 356599700378913/356975820378910. 356599700378921/356975820378928. 3
56599700378939/356975820378936. 356599700378947/356975820378944. 356599700378954/356975820378951. 356599700378962/356975820378969
. 356599700378970/356975820378977.356599700378988/356975820378985. 356599700378996/356975820378993. 356599700379002/3569758203790
09. 356599700379036/356975820379033. 356599700379044/356975820379041. 356599700379069/356975820379066. 356599700379093/3569758203
79090. 356599700379101/356975820379108. 356599700379127/356975820379124. 356599700379143/356975820379140. 356599700379150/3569758
20379157. 356599700379234/356975820379231. 356599700379267/356975820379264. 356599700379275/356975820379272. 356599700379283/3569
75820379280. 356599700379309/356975820379306. 356599700379317/356975820379314. 356599700379341/356975820379348. 356599700380117/3
56975820380114. 356599700382055/356975820382052. 356599700382345/356975820382342. 356599700382774/356975820382771. 35659970038279
0/356975820382797. 356599700384754/356975820384751. 356599700384911/356975820384918. 356599700384978/356975820384975. 35659970038
5512/356975820385519. 356599700386163/356975820386160. 356599700386262/356975820386269. 356599700386346/356975820386343. 35659970
0386437/356975820386434. 356599700386502/356975820386509. 356599700386510/356975820386517. 356599700386536/356975820386533. 35659
9700386767/356975820386764. 356599700386817/356975820386814. 356599700387096/356975820387093. 356599700387104/356975820387101. 35
6599700387153/356975820387150. 356599700387179/356975820387176. 356599700387229/356975820387226. 356599700387393/356975820387390.
356599700387708/356975820387705. 356599700387831/356975820387838. 356599700387872/356975820387879. 356599700388649/3569758203886
46. 356599700389589/356975820389586. 356599700390066/356975820390063. 356599700390405/356975820390402. 356599700390504/3569758203
90501. 356599700390603/356975820390600. 356599700390827/356975820390824. 356599700390975/356975820390972.356599700391007/35697582
0391004. 356599700391239/356975820391236. 356599700391346/356975820391343. 356599700391437/356975820391434. 356599700391452/35697
5820391459. 356599700391494/356975820391491. 356599700391544/356975820391541. 356599700391577/356975820391574. 356599700391601/35
6975820391608. 356599700391692/356975820391699. 356599700391700/356975820391707. 356599700392799/356975820392796. 356599700393151
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032026000378540-9
Espacio para uso exclusivo de la Entidad Recaudadora
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