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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
032026000611754-7
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. 116575016945171
43 . Año – Mes – Día
2026 – 04 – 23
44 . Documento de transporte
No. 023-02061485
45 . Año – Mes – Día
2026 – 04 – 19
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
9104294000
52 . Año – Mes – Día
2026 – 04 – 18
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.
158.00
72 . Peso neto kgs. dcms.
142.20
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
39.445.10
79 . Valor fletes USD
1.144.00 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
1.145.34
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: 598735-DECL: 2025705-DO: 893109395261- 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: 3112871592. ID DELIVERY:
6088219883. MERCANCIA MARCA: SAMSUNG REFERENCIA: SM-A175FZAFLTC, PRODUCTO: TELEFONO CELULAR GALAXY A17 LTE DUOS (CON ACCESORIOS
PARA USO Y NORMAL FUNCIONAMIENTO), COLOR: GRIS, MODELO: SM-A175F/DS, USO O DESTINO: PARA LA VENTA AL MAYOR (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
032026000611754
133. Feha: 202604 24
134 . Levante No. 032026000563836 135 . Fecha
2026 – 04 – 24
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 92032607453998
Fecha presentación 2026-04-24 17:10:35
Valor pagado $0.00
Fecha de Impresión: 2026-04-24 17:10:39
Page 1
SEC
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000611754-7
Subpartida : 8517130000
Página 1 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
Y AL DETAL./ /MOBILE,SM-A175F/DS,GRAY,LTC( QTY. 500,00 u )(500,00 PCE ); IMEIS: 350901806749052/351461266749059. 350901806765322/
351461266765329. 350901806773144/351461266773141. 350901806776139/351461266776136. 350901806808320/351461266808327. 3509018068083
53/351461266808350. 350901806808429/351461266808426. 350901806808452/351461266808459. 350901806808486/351461266808483. 3509018068
08502/351461266808509. 350901806808676/351461266808673. 350901806808684/351461266808681. 350901806808692/351461266808699. 3509018
06808726/351461266808723. 350901806808734/351461266808731.350901806808742/351461266808749. 350901806808759/351461266808756. 35090
1806808767/351461266808764. 350901806808775/351461266808772. 350901806808783/351461266808780. 350901806808817/351461266808814. 35
0901806808825/351461266808822. 350901806808833/351461266808830. 350901806808841/351461266808848. 350901806808858/351461266808855.
350901806808866/351461266808863. 350901806808882/351461266808889. 350901806808890/35146126 6808897. 350901806808908/351461266808
905. 350901806808916/351461266808913. 350901806808924/351461266808921. 350901806808932/351461266808939.350901806808940/3514612668
08947. 350901806808965/351461266808962. 350901806808973/351461266808970. 350901806808981/351461266808988. 350901806809005/3514612
66809002. 350901806809013/351461266809010. 350901806809021/351461266809028. 350901806809294/351461266809291. 350901806809302/3514
61266809309. 350901806809344/351461266809341. 350901806809393/351461266809390. 350901806809435/351461266809432. 350901806809443/3
51461266809440. 350901806809468/351461266809465. 350901806809484/351461266809481. 350901806809492/351461266809499. 35090180680954
2/351461266809549. 350901806809625/351461266809622. 350901806809633/351461266809630. 350901806809641/351461266809648. 35090180680
9799/351461266809796. 350901806809864/351461266809861. 350901806809880/351461266809887. 350901806809906/351461266809903. 35090180
6809948/351461266809945. 350901806809955/351461266809952. 350901806809971/351461266809978. 350901806809997/351461266809994. 35090
1806810003/351461266810000. 350901806810029/351461266810026. 350901806810037/351461266810034. 350901806810045/351461266810042. 35
0901806810052/351461266810059. 350901806810060/351461266810067. 350901806810078/351461266810075. 350901806810110/351461266810117.
350901806810169/351461266810166. 350901806810177/351461266810174. 350901806810193/351461266810190. 350901806810201/3514612668102
08. 350901806810219/351461266810216. 350901806810227/351461266810224. 350901806810268/351461266810265. 350901806810276/3514612668
10273. 350901806810284/351461266810281. 350901806810292/351461266810299. 350901806810300/351461266810307. 350901806810342/3514612
66810349. 350901806810367/351461266810364. 350901806810417/351461266810414. 350901806810441/351461266810448. 350901806810474/3514
61266810471. 350901806810516/351461266810513.350901806810524/351461266810521. 350901806810532/351461266810539. 350901806810540/35
1461266810547. 350901806810557/351461266810554. 350901806810565/351461266810562. 350901806810573/351461266810570. 350901806810623
/351461266810620. 350901806810649/351461266810646. 350901806810680/351461266810687. 350901806810698/351461266810695. 350901806810
714/351461266810711. 350901806810755/351461266810752. 350901806810771/351461266810778. 350901806810839/351461266810836. 350901806
810854/351461266810851. 350901806810862/351461266810869. 350901806810870/351461266810877.350901806810904/351461266810901. 3509018
06810912/351461266810919. 350901806810920/351461266810927. 350901806810938/351461266810935. 350901806810946/351461266810943. 3509
01806810953/351461266810950. 350901806810979/351461266810976. 350901806810995/351461266810992. 350901806811001/351461266811008. 3
50901806811019/351461266811016. 350901806811027/351461266811024. 350901806811035/351461266811032. 350901806811050/351461266811057
. 350901806811068/351461266811065. 350901806811100/351461266811107. 350901806811118/351461266811115. 350901806811142/351461266811
149. 350901806811159/351461266811156. 350901806811167/351461266811164. 350901806811175/351461266811172. 350901806811183/351461266
811180. 350901806811191/351461266811198. 350901806811225/351461266811222. 350901806811241/351461266811248. 350901806811258/351461
266811255. 350901806811274/351461266811271. 350901806811282/351461266811289. 350901806811316/351461266811313. 350901806811324/351
461266811321. 350901806811332/351461266811339. 350901806811357/351461266811354. 350901806811373/351461266811370. 350901806811381/
351461266811388. 350901806811399/351461266811396. 350901806811415/351461266811412. 350901806811423/351461266811420. 3509018068114
31/351461266811438. 350901806811456/351461266811453. 350901806811464/351461266811461. 350901806811472/351461266811479. 3509018068
11555/351461266811552. 350901806811589/351461266811586. 350901806811670/351461266811677. 350901806811860/351461266811867. 3509018
06811977/351461266811974. 350901806811993/351461266811990. 350901806812009/351461266812006. 350901806812264/351461266812261. 3509
01806812272/351461266812279. 350901806812298/351461266812295. 350901806812306/351461266812303. 350901806812371/351461266812378. 3
50901806812389/351461266812386.350901806812421/351461266812428. 350901806812454/351461266812451. 350901806812488/351461266812485.
350901806812496/351461266812493. 350901806812553/351461266812550. 350901806812595/351461266812592. 350901806812611/3514612668126
18. 350901806812637/351461266812634. 350901806812678/351461266812675. 350901806812736/351461266812733. 350901806812801/3514612668
12808. 350901806812819/351461266812816. 350901806812827/351461266812824. 350901806812843/351461266812840. 350901806812850/3514612
66812857. 350901806812876/351461266812873. 350901806812892/351461266812899.350901806812918/351461266812915. 350901806812926/35146
1266812923. 350901806812983/351461266812980. 350901806813015/351461266813012. 350901806813023/351461266813020. 350901806813049/35
1461266813046. 350901806813064/351461266813061. 350901806813072/351461266813079. 350901806813114/351461266813111. 350901806813155
/351461266813152. 350901806813221/351461266813228. 350901806813254/351461266813251. 350901806813429/351461266813426. 350901806813
577/351461266813574. 350901806813593/351461266813590. 350901806813643/351461266813640. 350901806813718/351461266813715. 350901806
813825/351461266813822. 350901806814138/351461266814135. 350901806814260/351461266814267. 350901806814310/351461266814317. 350901
806814351/351461266814358. 350901806814369/351461266814366. 350901806814377/351461266814374. 350901806814385/351461266814382. 350
901806814393/351461266814390. 350901806814401/351461266814408. 350901806814518/351461266814515. 350901806814526/351461266814523.
350901806814534/351461266814531. 350901806814542/351461266814549. 350901806814575/351461266814572. 350901806814591/35146126681459
8. 350901806814609/351461266814606. 350901806814617/351461266814614. 350901806814641/351461266814648. 350901806814674/35146126681
4671. 350901806814682/351461266814689. 350901806814690/351461266814697. 350901806814716/351461266814713. 350901806814732/35146126
6814739. 350901806814740/351461266814747. 350901806814757/351461266814754. 350901806814898/351461266814895. 350901806814906/35146
1266814903. 350901806814914/351461266814911. 350901806815002/351461266815009. 350901806815010/351461266815017. 350901806815044/35
1461266815041. 350901806815093/351461266815090. 350901806815168/351461266815165. 350901806815200/351461266815207. 350901806815242
/351461266815249.350901806815291/351461266815298. 350901806815341/351461266815348. 350901806815473/351461266815470. 3509018068154
99/351461266815496. 350901806815523/351461266815520. 350901806815531/351461266815538. 350901806815572/351461266815579. 3509018068
15622/351461266815629. 350901806815721/351461266815728. 350901806815770/351461266815777. 350901806815788/351461266815785. 3509018
06815796/351461266815793. 350901806815812/351461266815819. 350901806815879/351461266815876. 350901806815887/351461266815884. 3509
01806815903/351461266815900. 350901806816018/351461266816015.350901806816026/351461266816023. 350901806816042/351461266816049. 35
0901806816059/351461266816056. 350901806816125/351461266816122. 350901806816133/351461266816130. 350901806816141/351461266816148.
350901806816216/351461266816213. 350901806816224/351461266816221. 350901806816240/351461266816247. 350901806816323/3514612668163
20. 350901806816356/351461266816353. 350901806816364/351461266816361. 350901806816380/351461266816387. 350901806816398/3514612668
16395. 350901806816422/351461266816429. 350901806816513/351461266816510. 350901806816539/351461266816536. 350901806816547/3514612
66816544. 350901806816554/351461266816551. 350901806816562/351461266816569. 350901806816596/351461266816593. 350901806816661/3514
61266816668. 350901806816729/351461266816726. 350901806816752/351461266816759. 350901806816828/351461266816825. 350901806816836/3
51461266816833. 350901806816869/351461266816866. 350901806816877/351461266816874. 350901806817008/351461266817005. 35090180681742
0/351461266817427. 350901806817537/351461266817534. 350901806817545/351461266817542. 350901806817560/351461266817567. 35090180681
7586/351461266817583. 350901806817693/351461266817690. 350901806817735/351461266817732. 350901806817750/351461266817757. 35090180
6817826/351461266817823. 350901806817834/351461266817831. 350901806817925/351461266817922. 350901806817990/351461266817997. 35090
1806818097/351461266818094. 350901806818147/351461266818144. 350901806818162/351461266818169. 350901806818170/351461266818177. 35
0901806818196/351461266818193. 350901806818212/351461266818219. 350901806818220/351461266818227. 350901806818246/351461266818243.
032026000611754-7
Espacio para uso exclusivo de la Entidad Recaudadora
Page 2
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 032026000611754-7
Subpartida : 8517130000
Página 2 de 2
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
350901806818295/351461266818292. 350901806818311/351461266818318. 350901806818360/351461266818367. 350901806818386/3514612668183
83.350901806818444/351461266818441. 350901806818501/351461266818508. 350901806839291/351461266839298. 350901806839408/35146126683
9405. 350901806839440/351461266839447. 350901806839465/351461266839462. 350901806839473/351461266839470. 350901806839481/35146126
6839488. 350901806839499/351461266839496. 350901806839515/351461266839512. 350901806839523/351461266839520. 350901806839531/35146
1266839538. 350901806839549/351461266839546. 350901806839580/351461266839587. 350901806839598/351461266839595. 350901806839606/35
1461266839603. 350901806839614/351461266839611.350901806839622/351461266839629. 350901806839655/351461266839652. 350901806839663/
351461266839660. 350901806839713/351461266839710. 350901806839721/351461266839728. 350901806839739/351461266839736. 3509018068397
47/351461266839744. 350901806839754/351461266839751. 350901806839762/351461266839769. 350901806839788/351461266839785. 3509018068
39796/351461266839793. 350901806839804/351461266839801. 350901806839820/351461266839827. 350901806839838/351461266839835. 3509018
06839846/351461266839843. 350901806839853/351461266839850. 350901806839861/351461266839868. 350901806839879/351461266839876. 3509
01806839887/351461266839884. 350901806839895/351461266839892. 350901806839903/351461266839900. 350901806839960/351461266839967. 3
50901806839978/351461266839975. 350901806839986/351461266839983. 350901806840000/351461266840007. 350901806840018/351461266840015
. 350901806840034/351461266840031. 350901806840042/351461266840049. 350901806840075/351461266840072. 350901806840091/351461266840
098. 350901806840109/351461266840106. 350901806840125/351461266840122. 350901806840158/351461266840155. 350901806840166/351461266
840163. 350901806840208/351461266840205. 350901806840216/351461266840213. 350901806840224/351461266840221. 350901806840299/351461
266840296. 350901806840307/351461266840304. 350901806840315/351461266840312. 350901806840323/351461266840320. 350901806840331/351
461266840338. 350901806840349/351461266840346. 350901806840372/351461266840379. 350901806840414/351461266840411. 350901806840497/
351461266840494. 350901806840505/351461266840502. 350901806840521/351461266840528. 350901806840588/351461266840585. 3509018068406
04/351461266840601. 350901806840745/351461266840742. 350901806840752/351461266840759. 350901806840802/351461266840809.35090180684
0844/351461266840841. 350901806840851/351461266840858. 350901806840893/351461266840890. 350901806840901/351461266840908. 35090180
6840927/351461266840924. 350901806840935/351461266840932. 350901806840950/351461266840957. 350901806840968/351461266840965. 35090
1806841040/351461266841047. 350901806841057/351461266841054. 350901806841099/351461266841096. 350901806841107/351461266841104. 35
0901806841115/351461266841112. 350901806841123/351461266841120. 350901806841131/351461266841138. 350901806841164/351461266841161.
350901806841172/351461266841179.350901806841206/351461266841203. 350901806841313/351461266841310. 350901806841339/35146126684133
6. 350901806841347/351461266841344. 350901806841354/351461266841351. 350901806841362/351461266841369. 350901806841370/35146126684
1377. 350901806841388/351461266841385. 350901806841404/351461266841401. 350901806841412/351461266841419. 350901806841438/35146126
6841435. 350901806841446/351461266841443. 350901806841461/351461266841468. 350901806841479/351461266841476. 350901806841487/35146
1266841484. 350901806841503/351461266841500. 350901806841511/351461266841518. 350901806841537/351461266841534. 350901806841552/35
1461266841559. 350901806841594/351461266841591. 350901806841628/351461266841625. 350901806841636/351461266841633. 350901806841644
/351461266841641. 350901806841743/351461266841740. 350901806841750/351461266841757. 350901806841768/351461266841765. 350901806841
834/351461266841831. 350901806841958/351461266841955. 350901806842121/351461266842128. 350901806842147/351461266842144. 350901806
842360/351461266842367. 350901806842394/351461266842391. 350901806842444/351461266842441. 350901806842477/351461266842474. 350901
806842527/351461266842524. 350901806842592/351461266842599. 350901806842618/351461266842615. 350901806842667/351461266842664. 350
901806842741/351461266842748. 350901806842758/351461266842755. 350901806842766/351461266842763. 350901806842774/351461266842771.
350901806842808/351461266842805. 350901806842824/351461266842821. 350901806842832/351461266842839. 350901806842865/35146126684286
2. 350901806842915/351461266842912. 350901806842923/351461266842920. 350901806842972/351461266842979. 350901806843004/35146126684
3001. 350901806843038/351461266843035. 350901806843178/351461266843175. 350901806843236/351461266843233.350901806843244/351461266
843241. 350901806843277/351461266843274. 350901806843293/351461266843290. 350901806843319/351461266843316. 350901806843327/351461
266843324. 350901806843343/351461266843340. 350901806843350/351461266843357. 350901806843368/351461266843365. 350901806843376/351
461266843373. 350901806843384/351461266843381. 350901806843442/351461266843449. 350901806843459/351461266843456. 350901806843467/
351461266843464. 350901806843483/351461266843480. 350901806843491/351461266843498. 350901806843509/351461266843506. 3509018068435
17/351461266843514.350901806843525/351461266843522. 350901806843533/351461266843530. 350901806843541/351461266843548. 35090180684
3574/351461266843571. 350901806843582/351461266843589. 350901806843590/351461266843597. 350901806843616/351461266843613. 35090180
6843624/351461266843621. 350901806843657/351461266843654. 350901806843715/351461266843712. 350901806843863/351461266843860. 35090
1806843921/351461266843928. 350901806844093/351461266844090. 350901806844143/351461266844140. 350901806844168/351461266844165. 35
0901806844291/351461266844298. 350901806844457/351461266844454. 350901806844630/351461266844637. 350901806844945/351461266844942.
350901806844960/351461266844967. 350901806844986/351461266844983. 350901806845066/351461266845063. 350901806845132/3514612668451
39. 350901806845157/351461266845154. 350901806845173/351461266845170. 350901806845280/351461266845287. 350901806845439/3514612668
45436. 350901806845504/351461266845501. 350901806845546/351461266845543. 350901806845595/351461266845592. 350901806845645/3514612
66845642. 350901806845652/351461266845659. 350901806845678/351461266845675. 350901806845736/351461266845733. 350901806845777/3514
61266845774. 350901806845793/351461266845790. 350901806845983/351461266845980. 350901806845991/351461266845998. 350901806846007/3
51461266846004. 350901806846023/351461266846020. 350901806846346/351461266846343. 350901806846353/351461266846350. 35090180684637
9/351461266846376. 350901806846619/351461266846616. 350901806846627/351461266846624. 350901806846650/351461266846657. 35090180684
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032026000611754-7
Espacio para uso exclusivo de la Entidad Recaudadora
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