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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
032026000564189-3
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
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. 116575016914350
43 . Año – Mes – Día
2026 – 04 – 16
44 . Documento de transporte
No. HKL046470
45 . Año – Mes – Día
2026 – 04 – 12
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
6900422891
52 . Año – Mes – Día
2026 – 04 – 02
53 . Cod. país
procedencia
351
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.
3.642.93
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.
173.00
72 . Peso neto kgs. dcms.
155.70
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
23.326.64
79 . Valor fletes USD
1.437.63 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
90.217.489
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
90.217.489
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
0.82
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.438.45
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
24.765.09
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: 598116-DECL: 2024083-DO: 893108728261- 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: 3111913369. ID DELIVERY: 6088094774. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A075MZGDLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A07 LTE DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: VERDE, (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: Después de insp.: levante
No hay declaración posterior
Acta de inspección No.: 032026000048469
Inició: 2026-04-17 11:50:59 Finalizó: 2026-04-17 19:02:00
131 . Espacio reservado uso exclusivo Ministerio de Relaciones Exteriores 132 . No. Aceptación declaración
032026000564189
133. Feha: 202604 17
134 . Levante No. 032026000524422 135 . Fecha
2026 – 04 – 17
Firma funcionario responsable 136 . Nombre CAROLINA DE LOS ANGELES ACOSTA
137 . C.C. No. 52425879
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 92032607212394
Fecha presentación 2026-04-17 11:50:57
Valor pagado $0.00
Fecha de Impresión: 2026-04-17 19:37:37
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000564189-3
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,GREEN,LTC( QTY. 500,00 u )(500,00 PCE
); IMEIS: 357113743690083/359728853690082. 357113743690091/359728853690090. 357113743690109/359728853690108. 357113743690117/359
728853690116. 357113743690125/359728853690124. 357113743690133/359728853690132. 357113743690190/359728853690199. 357113743690208/
359728853690207. 357113743690216/359728853690215. 357113743690224/359728853690223. 357113743690232/359728853690231. 3571137436902
57/359728853690256. 357113743690265/359728853690264. 357113743690273/359728853690272. 357113743690281/359728853690280. 3571137436
90299/359728853690298. 357113743690315/359728853690314. 357113743690323/359728853690322. 357113743690331/359728853690330. 3571137
43690364/359728853690363. 357113743690794/359728853690793. 357113743690802/359728853690801. 357113743690851/359728853690850. 3571
13743690968/359728853690967. 357113743691057/359728853691056. 357113743691206/35972885369120 5. 357113743691263/359728853691262.
357113743691271/359728853691270. 357113743691339/359728853691338. 357113743691438/359728853691437. 357113743691479/35972885369147
8. 357113743691511/359728853691510. 357113743691552/359728853691551. 357113743691602/359728853691601. 357113743691644/35972885369
1643. 357113743691693/359728853691692. 357113743691743/359728853691742. 357113743691784/359728853691783. 357113743691818/35972885
3691817. 357113743691867/359728853691866. 357113743691891/359728853691890. 357113743691933/359728853691932. 357113743691974/35972
8853691973. 357113743691982/359728853691981. 357113743692006/359728853692005.357113743692063/359728853692062. 357113743692105/359
728853692104. 357113743692139/359728853692138. 357113743692147/359728853692146. 357113743692154/359728853692153. 357113743692162/
359728853692161. 357113743692196/359728853692195. 357113743692246/359728853692245. 357113743692295/359728853692294. 3571137436923
37/359728853692336. 357113743692410/359728853692419. 357113743692436/359728853692435. 357113743692444/359728853692443. 3571137436
92535/359728853692534. 357113743692667/359728853692666. 357113743692741/359728853692740. 357113743692774/359728853692773.35711374
3692808/359728853692807. 357113743692816/359728853692815. 357113743692824/359728853692823. 357113743692832/359728853692831. 35711
3743692857/359728853692856. 357113743692865/359728853692864. 357113743692907/359728853692906. 357113743692915/359728853692914. 35
7113743692956/359728853692955. 357113743692964/359728853692963. 357113743693012/359728853693011. 357113743693087/359728853693086.
357113743693426/359728853693425. 357113743693475/359728853693474. 357113743693509/359728853693508. 357113743693533/3597288536935
32. 357113743693558/359728853693557. 357113743693582/359728853693581. 357113743693590/359728853693599. 357113743693608/3597288536
93607. 357113743693699/359728853693698. 357113743693764/359728853693763. 357113743693772/359728853693771. 357113743693988/3597288
53693987. 357113743694002/359728853694001. 357113743694085/359728853694084. 357113743694093/359728853694092. 357113743694101/3597
28853694100. 357113743694168/359728853694167. 357113743694200/359728853694209. 357113743694218/359728853694217. 357113743694226/3
59728853694225. 357113743694234/359728853694233. 357113743694325/359728853694324. 357113743694457/359728853694456. 35711374369446
5/359728853694464. 357113743694515/359728853694514. 357113743694564/359728853694563. 357113743694614/359728853694613. 35711374369
4655/359728853694654. 357113743694754/359728853694753. 357113743694770/359728853694779. 357113743694838/359728853694837. 35711374
3694846/359728853694845. 357113743694903/359728853694902. 357113743695090/359728853695099. 357113743695124/359728853695123. 35711
3743695132/359728853695131. 357113743695223/359728853695222. 357113743695264/359728853695263. 357113743695330/359728853695339. 35
7113743695371/359728853695370. 357113743695413/359728853695412.357113743695421/359728853695420. 357113743695488/359728853695487.
357113743695504/359728853695503. 357113743695512/359728853695511. 357113743695520/359728853695529. 357113743695538/35972885369553
7. 357113743695611/359728853695610. 357113743695629/359728853695628. 357113743695637/359728853695636. 357113743695660/35972885369
5669. 357113743695678/359728853695677. 357113743695686/359728853695685. 357113743695694/359728853695693. 357113743695702/35972885
3695701. 357113743695710/359728853695719. 357113743695728/359728853695727. 357113743695736/359728853695735.357113743695744/359728
853695743. 357113743695751/359728853695750. 357113743695769/359728853695768. 357113743695777/359728853695776. 357113743695785/359
728853695784. 357113743695793/359728853695792. 357113743695801/359728853695800. 357113743695819/359728853695818. 357113743695827/
359728853695826. 357113743695835/359728853695834. 357113743695843/359728853695842. 357113743695868/359728853695867. 3571137436958
76/359728853695875. 357113743695884/359728853695883. 357113743695892/359728853695891. 357113743695900/359728853695909. 3571137436
95918/359728853695917. 357113743695926/359728853695925. 357113743695942/359728853695941. 357113743695959/359728853695958. 3571137
43695967/359728853695966. 357113743695975/359728853695974. 357113743695983/359728853695982. 357113743695991/359728853695990. 3571
13743696007/359728853696006. 357113743696015/359728853696014. 357113743696023/359728853696022. 357113743696031/359728853696030. 3
57113743696049/359728853696048. 357113743696056/359728853696055. 357113743696064/359728853696063. 357113743696080/359728853696089
. 357113743696098/359728853696097. 357113743696106/359728853696105. 357113743696114/359728853696113. 357113743696122/359728853696
121. 357113743696130/359728853696139. 357113743696148/359728853696147. 357113743696155/359728853696154. 357113743696163/359728853
696162. 357113743696171/359728853696170. 357113743696189/359728853696188. 357113743696197/359728853696196. 357113743696213/359728
853696212. 357113743696221/359728853696220. 357113743696239/359728853696238. 357113743696247/359728853696246. 357113743696254/359
728853696253. 357113743696262/359728853696261. 357113743696270/359728853696279. 357113743696296/359728853696295. 357113743696312/
359728853696311. 357113743696338/359728853696337.357113743696346/359728853696345. 357113743696353/359728853696352. 35711374369637
9/359728853696378. 357113743696403/359728853696402. 357113743696445/359728853696444. 357113743696494/359728853696493. 35711374369
6528/359728853696527. 357113743696536/359728853696535. 357113743696569/359728853696568. 357113743696601/359728853696600. 35711374
3696635/359728853696634. 357113743696668/359728853696667. 357113743696700/359728853696709. 357113743696767/359728853696766. 35711
3743696783/359728853696782. 357113743696791/359728853696790. 357113743696809/359728853696808.357113743696817/359728853696816. 357
113743696833/359728853696832. 357113743696858/359728853696857. 357113743696866/359728853696865. 357113743696874/359728853696873.
357113743696882/359728853696881. 357113743696908/359728853696907. 357113743696916/359728853696915. 357113743696924/35972885369692
3. 357113743696932/359728853696931. 357113743696940/359728853696949. 357113743696957/359728853696956. 357113743696965/35972885369
6964. 357113743696973/359728853696972. 357113743696981/359728853696980. 357113743696999/359728853696998. 357113743697005/35972885
3697004. 357113743697013/359728853697012. 357113743697021/359728853697020. 357113743697039/359728853697038. 357113743697047/35972
8853697046. 357113743697054/359728853697053. 357113743697062/359728853697061. 357113743697070/359728853697079. 357113743697088/35
9728853697087. 357113743697096/359728853697095. 357113743697104/359728853697103. 357113743697112/359728853697111. 357113743697120
/359728853697129. 357113743697138/359728853697137. 357113743697146/359728853697145. 357113743697153/359728853697152. 357113743697
161/359728853697160. 357113743697179/359728853697178. 357113743697187/359728853697186. 357113743697195/359728853697194. 357113743
697203/359728853697202. 357113743697211/359728853697210. 357113743697229/359728853697228. 357113743697245/359728853697244. 357113
743697252/359728853697251. 357113743697260/359728853697269. 357113743697278/359728853697277. 357113743697286/359728853697285. 357
113743697294/359728853697293. 357113743697302/359728853697301. 357113743697310/359728853697319. 357113743697328/359728853697327.
357113743697344/359728853697343. 357113743697351/359728853697350. 357113743697369/359728853697368. 357113743697377/35972885369737
6. 357113743697385/359728853697384.357113743697393/359728853697392. 357113743697401/359728853697400. 357113743697419/359728853697
418. 357113743697435/359728853697434. 357113743697443/359728853697442. 357113743697450/359728853697459. 357113743697468/359728853
697467. 357113743697476/359728853697475. 357113743697500/359728853697509. 357113743697518/359728853697517. 357113743697526/359728
853697525. 357113743697567/359728853697566. 357113743697591/359728853697590. 357113743697609/359728853697608. 357113743697617/359
728853697616. 357113743697625/359728853697624. 357113743697633/359728853697632.357113743697641/359728853697640. 357113743697658/3
59728853697657. 357113743697666/359728853697665. 357113743697674/359728853697673. 357113743697682/359728853697681. 35711374369769
0/359728853697699. 357113743697708/359728853697707. 357113743697716/359728853697715. 357113743697724/359728853697723. 35711374369
7732/359728853697731. 357113743697740/359728853697749. 357113743697757/359728853697756. 357113743697773/359728853697772. 35711374
3697781/359728853697780. 357113743697799/359728853697798. 357113743697815/359728853697814. 357113743697823/359728853697822. 35711
032026000564189-3
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000564189-3
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
3743697831/359728853697830. 357113743697849/359728853697848. 357113743697856/359728853697855. 357113743697864/359728853697863. 35
7113743697872/359728853697871. 357113743697880/359728853697889. 357113743697898/359728853697897. 357113743697906/359728853697905.
357113743697914/359728853697913. 357113743697922/359728853697921. 357113743697955/359728853697954. 357113743697963/3597288536979
62. 357113743697971/359728853697970. 357113743697989/359728853697988. 357113743698003/359728853698002. 357113743698029/3597288536
98028. 357113743698037/359728853698036. 357113743698052/359728853698051. 357113743698060/359728853698069. 357113743698078/3597288
53698077. 357113743698086/359728853698085. 357113743698094/359728853698093. 357113743698102/359728853698101. 357113743698110/3597
28853698119. 357113743698128/359728853698127. 357113743698136/359728853698135. 357113743698144/359728853698143. 357113743698151/3
59728853698150. 357113743698169/359728853698168. 357113743698177/359728853698176. 357113743698185/359728853698184. 35711374369819
3/359728853698192. 357113743698201/359728853698200. 357113743698219/359728853698218. 357113743698227/359728853698226. 35711374369
8235/359728853698234.357113743698243/359728853698242. 357113743698250/359728853698259. 357113743698268/359728853698267. 357113743
698276/359728853698275. 357113743698284/359728853698283. 357113743698292/359728853698291. 357113743698300/359728853698309. 357113
743698318/359728853698317. 357113743698326/359728853698325. 357113743698334/359728853698333. 357113743698342/359728853698341. 357
113743698359/359728853698358. 357113743698367/359728853698366. 357113743698383/359728853698382. 357113743698409/359728853698408.
357113743698417/359728853698416. 357113743698425/359728853698424.357113743698433/359728853698432. 357113743698441/359728853698440
. 357113743698458/359728853698457. 357113743698466/359728853698465. 357113743698474/359728853698473. 357113743698482/359728853698
481. 357113743698490/359728853698499. 357113743698508/359728853698507. 357113743698516/359728853698515. 357113743698524/359728853
698523. 357113743698532/359728853698531. 357113743698540/359728853698549. 357113743698557/359728853698556. 357113743698565/359728
853698564. 357113743698573/359728853698572. 357113743698581/359728853698580. 357113743698599/359728853698598. 357113743698607/359
728853698606. 357113743698615/359728853698614. 357113743698623/359728853698622. 357113743698631/359728853698630. 357113743698649/
359728853698648. 357113743698664/359728853698663. 357113743698672/359728853698671. 357113743698680/359728853698689. 3571137436986
98/359728853698697. 357113743698706/359728853698705. 357113743698714/359728853698713. 357113743698722/359728853698721. 3571137436
98730/359728853698739. 357113743698748/359728853698747. 357113743698755/359728853698754. 357113743698763/359728853698762. 3571137
43698771/359728853698770. 357113743698789/359728853698788. 357113743698797/359728853698796. 357113743698805/359728853698804. 3571
13743698813/359728853698812. 357113743698821/359728853698820. 357113743698847/359728853698846. 357113743698854/359728853698853. 3
57113743698862/359728853698861. 357113743698870/359728853698879. 357113743698896/359728853698895. 357113743698904/359728853698903
. 357113743698912/359728853698911. 357113743698920/359728853698929. 357113743698938/359728853698937. 357113743698946/359728853698
945. 357113743698953/359728853698952. 357113743698961/359728853698960. 357113743698979/359728853698978. 357113743698987/359728853
698986.357113743698995/359728853698994. 357113743699001/359728853699000. 357113743699019/359728853699018. 357113743699027/3597288
53699026. 357113743699035/359728853699034. 357113743699043/359728853699042. 357113743699050/359728853699059. 357113743699068/3597
28853699067. 357113743699076/359728853699075. 357113743699084/359728853699083. 357113743699092/359728853699091. 357113743699100/3
59728853699109. 357113743699118/359728853699117. 357113743699126/359728853699125. 357113743699134/359728853699133. 35711374369914
2/359728853699141. 357113743699159/359728853699158.357113743699167/359728853699166. 357113743699175/359728853699174. 357113743699
191/359728853699190. 357113743699209/359728853699208. 357113743699217/359728853699216. 357113743699225/359728853699224. 357113743
699233/359728853699232. 357113743699241/359728853699240. 357113743699266/359728853699265. 357113743699274/359728853699273. 357113
743699282/359728853699281. 357113743699290/359728853699299. 357113743699308/359728853699307. 357113743699316/359728853699315. 357
113743699324/359728853699323. 357113743699332/359728853699331. 357113743699340/359728853699349. 357113743699357/359728853699356.
357113743699365/359728853699364. 357113743699373/359728853699372. 357113743699381/359728853699380. 357113743699399/35972885369939
8. 357113743699407/359728853699406. 357113743699415/359728853699414. 357113743699423/359728853699422. 357113743699449/35972885369
9448. 357113743699456/359728853699455. 357113743699464/359728853699463. 357113743699472/359728853699471. 357113743699480/35972885
3699489. 357113743699498/359728853699497. 357113743699506/359728853699505. 357113743699514/359728853699513. 357113743699530/35972
8853699539. 357113743699548/359728853699547. 357113743699555/359728853699554. 357113743699563/359728853699562. 357113743699571/35
9728853699570. 357113743699589/359728853699588. 357113743699597/359728853699596. 357113743699605/359728853699604. 357113743699613
/359728853699612. 357113743699621/359728853699620. 357113743699639/359728853699638. 357113743699647/359728853699646. 357113743699
654/359728853699653. 357113743699662/359728853699661. 357113743699670/359728853699679. 357113743699688/359728853699687. 357113743
699696/359728853699695. 357113743699704/359728853699703. 357113743699712/359728853699711. 357113743699738/359728853699737.3571137
43699746/359728853699745. 357113743699753/359728853699752. 357113743699761/359728853699760. 357113743699779/359728853699778. 3571
13743699787/359728853699786. 357113743699795/359728853699794. 357113743699803/359728853699802. 357113743699811/359728853699810. 3
57113743699829/359728853699828. 357113743699837/359728853699836. 357113743699845/359728853699844. 357113743699852/359728853699851
. 357113743699860/359728853699869. 357113743699878/359728853699877. 357113743699894/359728853699893. 357113743699902/359728853699
901. 357113743699928/359728853699927.357113743699936/359728853699935. 357113743699951/359728853699950. 357113743699969/3597288536
99968. 357113743699977/359728853699976. 357113743699993/359728853699992. 357113743700007/359728853700006. 357113743700023/3597288
53700022. 357113743700031/359728853700030. 357113743700049/359728853700048. 357113743700056/359728853700055. 357113743700064/3597
28853700063. 357113743700080/359728853700089. 357113743700098/359728853700097. 357113743700114/359728853700113. 357113743700122/3
59728853700121. 357113743700130/359728853700139. 357113743700155/359728853700154. 357113743700171/359728853700170XXXXXXXXXXXXXXXX
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032026000564189-3
Espacio para uso exclusivo de la Entidad Recaudadora
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