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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
032026000585748-0
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. 116575016931925
43 . Año – Mes – Día
2026 – 04 – 20
44 . Documento de transporte
No. 023-01986983
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
9104277575
52 . Año – Mes – Día
2026 – 04 – 11
53 . Cod. país
procedencia
855
54 . Cod. Modo
Transporte
4
55 . Código de
Bandera
249
56 . Cod. Depto
destino
0
57 . Empresa transportadora
FEDERAL EXPRESS CORPORATION
58 . Tasa de cambio $ cvs.
3.615.10
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.
162.00
72 . Peso neto kgs. dcms.
145.80
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
39.305.10
79 . Valor fletes USD
1.284.00 Concepto % Base Total Liquidado ($) Total a pagar con esta
declaración ($) Total Liquidado (USD)
Arancel
92
0.00
93
146.738.500
94
0
95
0
96
0.00
I.V.A.
97
0.00
98
146.738.500
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
1.34
81 . Valor Otros Gastos USD
0
82 . Sumatoria de
fletes, seguros
y otros gastos USD
1.285.34
83 . Ajuste valor USD
0.00
84 . Valor aduana
USD
40.590.44
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: 597676-DECL: 2023043-DO: 893108680261- 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: 3112423157. ID DELIVERY: 6088095383. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A175FZKFLTC, PRODU
CTO: TELEFONO CELULAR GALAXY A17 LTE DUOS (CON ACCESORIOS PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: NEGRO, (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
032026000585748
133. Feha: 202604 21
134 . Levante No. 032026000540114 135 . Fecha
2026 – 04 – 21
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 92032607319807
Fecha presentación 2026-04-21 16:00:45
Valor pagado $0.00
Fecha de Impresión: 2026-04-21 16:00:51
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000585748-0
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
MODELO: SM-A175F/DS, USO O DESTINO: PARA LA VENTA AL MAYOR Y AL DETAL/ /MOBILE,SM-A175F/DS,BLACK,LTC( QTY. 500,00 u )(500,00 PCE
); IMEIS: 350901806704958/351461266704955. 350901806704966/351461266704963. 350901806704982/351461266704989. 350901806704990/3514
61266704997. 350901806705005/351461266705002. 350901806705013/351461266705010. 350901806705039/351461266705036. 350901806705047/3
51461266705044. 350901806705062/351461266705069.350901806705070/351461266705077. 350901806705088/351461266705085. 350901806705096
/351461266705093. 350901806705104/351461266705101. 350901806705112/351461266705119. 350901806705120/351461266705127. 350901806705
146/351461266705143. 350901806705153/351461266705150. 350901806705161/351461266705168. 350901806705187/351461266705184. 350901806
705203/351461266705200. 350901806705229/351461266705226. 350901806705435/351461266705432. 350901806705450/351461266705457. 350901
806705476/351461266705473. 350901806705484/351461266705481. 350901806705492/351461266705499 . 350901806705500/351461266705507. 35
0901806705518/351461266705515. 350901806705526/351461266705523. 350901806705591/351461266705598. 350901806705617/351461266705614.
350901806705625/351461266705622. 350901806705633/351461266705630. 350901806705641/351461266705648. 350901806705658/3514612667056
55. 350901806705666/351461266705663. 350901806705732/351461266705739. 350901806705773/351461266705770. 350901806705807/3514612667
05804. 350901806705831/351461266705838. 350901806705930/351461266705937. 350901806705948/351461266705945. 350901806705955/3514612
66705952. 350901806705963/351461266705960. 350901806705971/351461266705978. 350901806705989/351461266705986. 350901806706011/3514
61266706018. 350901806706029/351461266706026. 350901806706037/351461266706034. 350901806706045/351461266706042. 350901806706060/3
51461266706067. 350901806706086/351461266706083. 350901806706136/351461266706133. 350901806706144/351461266706141. 35090180670617
7/351461266706174. 350901806706185/351461266706182. 350901806706201/351461266706208. 350901806706219/351461266706216. 35090180670
6250/351461266706257. 350901806706268/351461266706265. 350901806706276/351461266706273. 350901806706292/351461266706299.350901806
706300/351461266706307. 350901806706318/351461266706315. 350901806706326/351461266706323. 350901806706334/351461266706331. 350901
806706359/351461266706356. 350901806706375/351461266706372. 350901806706383/351461266706380. 350901806706391/351461266706398. 350
901806706409/351461266706406. 350901806706417/351461266706414. 350901806706425/351461266706422. 350901806706433/351461266706430.
350901806706441/351461266706448. 350901806706458/351461266706455. 350901806706466/351461266706463. 350901806706482/35146126670648
9. 350901806706490/351461266706497.350901806706516/351461266706513. 350901806706524/351461266706521. 350901806706540/351461266706
547. 350901806706557/351461266706554. 350901806706565/351461266706562. 350901806706599/351461266706596. 350901806706623/351461266
706620. 350901806706631/351461266706638. 350901806706656/351461266706653. 350901806706664/351461266706661. 350901806706706/351461
266706703. 350901806706730/351461266706737. 350901806706763/351461266706760. 350901806706839/351461266706836. 350901806706854/351
461266706851. 350901806706904/351461266706901. 350901806706920/351461266706927. 350901806706938/351461266706935. 350901806707035/
351461266707032. 350901806707043/351461266707040. 350901806707068/351461266707065. 350901806707076/351461266707073. 3509018067078
37/351461266707834. 350901806707860/351461266707867. 350901806707894/351461266707891. 350901806707936/351461266707933. 3509018067
07951/351461266707958. 350901806707969/351461266707966. 350901806707985/351461266707982. 350901806707993/351461266707990. 3509018
06708041/351461266708048. 350901806708066/351461266708063. 350901806708074/351461266708071. 350901806708751/351461266708758. 3509
01806709338/351461266709335. 350901806709361/351461266709368. 350901806709379/351461266709376. 350901806709395/351461266709392. 3
50901806709486/351461266709483. 350901806709932/351461266709939. 350901806710039/351461266710036. 350901806710088/351461266710085
. 350901806710187/351461266710184. 350901806710195/351461266710192. 350901806710211/351461266710218. 350901806710526/351461266710
523. 350901806710740/351461266710747. 350901806710799/351461266710796. 350901806710849/351461266710846. 350901806710856/351461266
710853. 350901806710864/351461266710861. 350901806710872/351461266710879. 350901806710906/351461266710903.350901806710948/3514612
66710945. 350901806710997/351461266710994. 350901806711003/351461266711000. 350901806711029/351461266711026. 350901806711060/3514
61266711067. 350901806711078/351461266711075. 350901806711110/351461266711117. 350901806711136/351461266711133. 350901806711151/3
51461266711158. 350901806711185/351461266711182. 350901806711201/351461266711208. 350901806711219/351461266711216. 35090180671122
7/351461266711224. 350901806711235/351461266711232. 350901806711243/351461266711240. 350901806711250/351461266711257. 35090180671
1268/351461266711265.350901806711276/351461266711273. 350901806711284/351461266711281. 350901806711292/351461266711299. 350901806
711300/351461266711307. 350901806711318/351461266711315. 350901806711334/351461266711331. 350901806711706/351461266711703. 350901
806711714/351461266711711. 350901806711854/351461266711851. 350901806711862/351461266711869. 350901806711870/351461266711877. 350
901806711912/351461266711919. 350901806711938/351461266711935. 350901806711946/351461266711943. 350901806711953/351461266711950.
350901806712043/351461266712040. 350901806712415/351461266712412. 350901806712530/351461266712537. 350901806712639/35146126671263
6. 350901806712712/351461266712719. 350901806712746/351461266712743. 350901806712761/351461266712768. 350901806712779/35146126671
2776. 350901806712829/351461266712826. 350901806712837/351461266712834. 350901806712852/351461266712859. 350901806712878/35146126
6712875. 350901806712886/351461266712883. 350901806712894/351461266712891. 350901806712902/351461266712909. 350901806712910/35146
1266712917. 350901806712928/351461266712925. 350901806712944/351461266712941. 350901806713009/351461266713006. 350901806713066/35
1461266713063. 350901806713132/351461266713139. 350901806713371/351461266713378. 350901806713595/351461266713592. 350901806713694
/351461266713691. 350901806713710/351461266713717. 350901806713744/351461266713741. 350901806713751/351461266713758. 350901806713
769/351461266713766. 350901806713793/351461266713790. 350901806713801/351461266713808. 350901806713819/351461266713816. 350901806
713827/351461266713824. 350901806713850/351461266713857. 350901806714098/351461266714095. 350901806714106/351461266714103. 350901
806714130/351461266714137. 350901806714148/351461266714145. 350901806714155/351461266714152.350901806714171/351461266714178. 3509
01806714189/351461266714186. 350901806714197/351461266714194. 350901806714205/351461266714202. 350901806714213/351461266714210. 3
50901806714221/351461266714228. 350901806714239/351461266714236. 350901806714247/351461266714244. 350901806714288/351461266714285
. 350901806714312/351461266714319. 350901806714338/351461266714335. 350901806714346/351461266714343. 350901806714361/351461266714
368. 350901806714379/351461266714376. 350901806714403/351461266714400. 350901806714411/351461266714418. 350901806714429/351461266
714426.350901806714775/351461266714772. 350901806714791/351461266714798. 350901806714817/351461266714814. 350901806714866/3514612
66714863. 350901806714924/351461266714921. 350901806715525/351461266715522. 350901806715624/351461266715621. 350901806715657/3514
61266715654. 350901806716168/351461266716165. 350901806716333/351461266716330. 350901806716416/351461266716413. 350901806716507/3
51461266716504. 350901806716598/351461266716595. 350901806716853/351461266716850. 350901806716960/351461266716967. 35090180671713
3/351461266717130. 350901806717141/351461266717148. 350901806717158/351461266717155. 350901806717182/351461266717189. 35090180671
7190/351461266717197. 350901806717216/351461266717213. 350901806717737/351461266717734. 350901806717802/351461266717809. 35090180
6717810/351461266717817. 350901806717877/351461266717874. 350901806717943/351461266717940. 350901806718024/351461266718021. 35090
1806718115/351461266718112. 350901806718131/351461266718138. 350901806718206/351461266718203. 350901806718719/351461266718716. 35
0901806718818/351461266718815. 350901806718909/351461266718906. 350901806719709/351461266719706. 350901806719725/351461266719722.
350901806719931/351461266719938. 350901806720103/351461266720100. 350901806720368/351461266720365. 350901806720517/3514612667205
14. 350901806720525/351461266720522. 350901806720657/351461266720654. 350901806720673/351461266720670. 350901806720681/3514612667
20688. 350901806720780/351461266720787. 350901806720798/351461266720795. 350901806720806/351461266720803. 350901806720822/3514612
66720829. 350901806720848/351461266720845. 350901806720913/351461266720910. 350901806721697/351461266721694. 350901806722109/3514
61266722106. 350901806722455/351461266722452. 350901806722471/351461266722478.350901806722489/351461266722486. 350901806722513/35
1461266722510. 350901806722521/351461266722528. 350901806722919/351461266722916. 350901806722935/351461266722932. 350901806722943
/351461266722940. 350901806723016/351461266723013. 350901806723057/351461266723054. 350901806723297/351461266723294. 350901806723
636/351461266723633. 350901806723693/351461266723690. 350901806723727/351461266723724. 350901806723750/351461266723757. 350901806
724113/351461266724110. 350901806724154/351461266724151. 350901806724170/351461266724177. 350901806724246/351461266724243.3509018
032026000585748-0
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000585748-0
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
06724287/351461266724284. 350901806724329/351461266724326. 350901806724352/351461266724359. 350901806725029/351461266725026. 3509
01806725060/351461266725067. 350901806725417/351461266725414. 350901806725888/351461266725885. 350901806726076/351461266726073. 3
50901806726134/351461266726131. 350901806726407/351461266726404. 350901806726472/351461266726479. 350901806726498/351461266726495
. 350901806726605/351461266726602. 350901806726670/351461266726677. 350901806726696/351461266726693. 350901806726704/351461266726
701. 350901806727058/351461266727055. 350901806727538/351461266727535. 350901806727561/351461266727568. 350901806727819/351461266
727816. 350901806728445/351461266728442. 350901806729047/351461266729044. 350901806729096/351461266729093. 350901806729104/351461
266729101. 350901806729195/351461266729192. 350901806729427/351461266729424. 350901806730912/351461266730919. 350901806731159/351
461266731156. 350901806731191/351461266731198. 350901806731837/351461266731834. 350901806731878/351461266731875. 350901806732009/
351461266732006. 350901806732017/351461266732014. 350901806732090/351461266732097. 350901806732157/351461266732154. 3509018067321
73/351461266732170. 350901806732223/351461266732220. 350901806732397/351461266732394. 350901806732710/351461266732717. 3509018067
32736/351461266732733. 350901806732959/351461266732956. 350901806732975/351461266732972. 350901806733023/351461266733020. 3509018
06733098/351461266733095. 350901806733254/351461266733251. 350901806733379/351461266733376. 350901806733387/351461266733384. 3509
01806733395/351461266733392. 350901806733411/351461266733418. 350901806733486/351461266733483. 350901806733551/351461266733558. 3
50901806733676/351461266733673. 350901806733726/351461266733723.350901806733973/351461266733970. 350901806734096/351461266734093.
350901806734112/351461266734119. 350901806734153/351461266734150. 350901806734179/351461266734176. 350901806734195/3514612667341
92. 350901806734336/351461266734333. 350901806734344/351461266734341. 350901806734351/351461266734358. 350901806734385/3514612667
34382. 350901806734393/351461266734390. 350901806734427/351461266734424. 350901806734435/351461266734432. 350901806734484/3514612
66734481. 350901806734492/351461266734499. 350901806734575/351461266734572. 350901806734609/351461266734606.350901806734690/35146
1266734697. 350901806734880/351461266734887. 350901806734963/351461266734960. 350901806735044/351461266735041. 350901806735069/35
1461266735066. 350901806735077/351461266735074. 350901806735085/351461266735082. 350901806735093/351461266735090. 350901806735119
/351461266735116. 350901806735127/351461266735124. 350901806735341/351461266735348. 350901806735648/351461266735645. 350901806735
747/351461266735744. 350901806735762/351461266735769. 350901806735770/351461266735777. 350901806735812/351461266735819. 350901806
735820/351461266735827. 350901806735846/351461266735843. 350901806735861/351461266735868. 350901806735887/351461266735884. 350901
806735903/351461266735900. 350901806735937/351461266735934. 350901806735960/351461266735967. 350901806735978/351461266735975. 350
901806735994/351461266735991. 350901806736240/351461266736247. 350901806736307/351461266736304. 350901806736331/351461266736338.
350901806736398/351461266736395. 350901806736638/351461266736635. 350901806736646/351461266736643. 350901806736653/35146126673665
0. 350901806736661/351461266736668. 350901806736679/351461266736676. 350901806736695/351461266736692. 350901806736711/35146126673
6718. 350901806736729/351461266736726. 350901806736737/351461266736734. 350901806736745/351461266736742. 350901806736760/35146126
6736767. 350901806736794/351461266736791. 350901806736802/351461266736809. 350901806736828/351461266736825. 350901806736927/35146
1266736924. 350901806736935/351461266736932. 350901806737040/351461266737047. 350901806737271/351461266737278. 350901806737412/35
1461266737419. 350901806737420/351461266737427. 350901806737735/351461266737732. 350901806737776/351461266737773. 350901806737818
/351461266737815. 350901806739657/351461266739654.350901806739673/351461266739670. 350901806739749/351461266739746. 3509018067397
80/351461266739787. 350901806739954/351461266739951. 350901806739962/351461266739969. 350901806739996/351461266739993. 3509018067
40010/351461266740017. 350901806740218/351461266740215. 350901806773920/351461266773927. 350901806773953/351461266773950. 3509018
06773961/351461266773968. 350901806773979/351461266773976. 350901806773987/351461266773984. 350901806773995/351461266773992. 3509
01806774019/351461266774016. 350901806774027/351461266774024. 350901806774035/351461266774032.350901806774043/351461266774040. 35
0901806774068/351461266774065. 350901806774076/351461266774073. 350901806774084/351461266774081. 350901806774092/351461266774099.
350901806774100/351461266774107. 350901806774118/351461266774115. 350901806774126/351461266774123. 350901806774134/3514612667741
31. 350901806774142/351461266774149. 350901806774159/351461266774156. 350901806774167/351461266774164. 350901806774175/3514612667
74172. 350901806774191/351461266774198. 350901806774217/351461266774214. 350901806774241/351461266774248. 350901806774258/3514612
66774255. 350901806774266/351461266774263. 350901806774274/351461266774271. 350901806774290/351461266774297. 350901806774308/3514
61266774305. 350901806774316/351461266774313. 350901806774332/351461266774339. 350901806774340/351461266774347. 350901806774357/3
51461266774354. 350901806774373/351461266774370. 350901806774381/351461266774388. 350901806774597/351461266774594. 35090180677460
5/351461266774602. 350901806774613/351461266774610. 350901806774621/351461266774628. 350901806774639/351461266774636. 35090180677
4647/351461266774644. 350901806774654/351461266774651. 350901806774662/351461266774669. 350901806774670/351461266774677. 35090180
6774688/351461266774685. 350901806774696/351461266774693. 350901806774704/351461266774701. 350901806774712/351461266774719. 35090
1806774720/351461266774727. 350901806774738/351461266774735. 350901806774746/351461266774743. 350901806774753/351461266774750. 35
0901806774761/351461266774768. 350901806774779/351461266774776. 350901806774787/351461266774784. 350901806774795/351461266774792.
350901806774811/351461266774818. 350901806774829/351461266774826. 350901806774837/351461266774834. 350901806774845/3514612667748
42. 350901806774852/351461266774859.350901806774860/351461266774867. 350901806774886/351461266774883. 350901806774894/35146126677
4891. 350901806774910/351461266774917. 350901806774936/351461266774933. 350901806774944/351461266774941. 350901806774951/35146126
6774958. 350901806774969/351461266774966. 350901806774977/351461266774974. 350901806774985/351461266774982. 350901806775016/35146
1266775013. 350901806775024/351461266775021. 350901806775032/351461266775039. 350901806775073/351461266775070. 350901806775107/35
1461266775104. 350901806775115/351461266775112. 350901806775990/351461266775997.350901806776006/351461266776003XXXXXXXXXXXXXXXXXX
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032026000585748-0
Espacio para uso exclusivo de la Entidad Recaudadora
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