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REPÚBLICA DE COLOMBIA
Declaración de Importación
Privada
500
1. Año 2024
Espacio reservado para la DIAN (Antes de diligenciar este formulario lea cuidadosamente las instrucciones)
4. Número de formulario
352024000307287-9
5 . Número de Identificación Tributaria (NIT)
830028931 13 . Dirección
CR 7 113 43 OF 607
6 . DV. 5
11 . Apellidos y nombres o Razón Social
SAMSUNG ELECTRONICS COLOMBIA S.A.
15 . Teléfono 12 . Cód. Admón. 16 . Cód. Dpto 17 . Cód. Ciudad Municipio
4870707 35 11 001
24 . Número de Identificación Tributaria (NIT)
860536003
29 . Número documento de identificación
14321990
25 . DV. 3
26 . Razón social del declarante autorizado 27 . Tipo usuario 28 . Cód. usuario
AGENCIA DE ADUANAS ABC REPECEV S.A.S. NIVEL 1 26 99 30 . Apellidos y nombres
DOMINGO TORRES FUENTES
31 . Clase 32 . Tipo declaración 33 . Cod. 34 .No.Formulario Anterior 35 . Año – Mes – Día 36 . Cod. Admón. 37 . Declaración de Exportación 38 . Año – Mes – Día 39 . Cod. Admón. Importador Anticipada 3 XXXXXXXXXXXXXX XXXX – XX – XX XX No. XXXXXXXXXXXXXXX XXXX – XX – XX XX
02
40 . Cod. lugar ingreso 41 . Cod. Depósito 42 . Manifiesto de carga 43 . Año – Mes – Día 44 . Documento de transporte 45 . Año – Mes – Día de las mercancías 99900 No. 116575014534391 2024 – 07 – 02 No. ONEYSGNEC1161300 2024 – 05 – 13
BUN
46 . Nombre exportador o proveedor en el exterior 47 . Ciudad 48 . Cod.País Exportador SAMSUNG ELECTRONICS CO., LTD GYEONGGI-DO 190
49 . Dirección exportador o proveedor en el exterior 50 . E-mail
129, SAMSUNG-RO, YEONGTONG-GU SUWON 16677 010-8705-6749
51 . No. de factura 52 . Año – Mes – Día 53 . Cod. país 6900265458 2024 – 05 – 13 procedencia 855
54 . Cod. Modo Transporte
1
55 . Código de Bandera
434
56 . Cod. Depto destino
0
57 . Empresa transportadora 58 . Tasa de cambio $ cvs. CIA TRANSPORTADORA S.A.
4.175.96
S
59 . Subpartida arancelaria 60 . Cod. 8528520000 Complementario
XX
61 . Cod. Suplementario
XX
62 . Cod. Modalidad C100
63 . No. cuotas o meses
XX
64 . Valor cuota USD XXXX
65 . Periodicidad del pago de la cuota
XX
66 . Cod. país 67 . Cod. Acuerdo de origen XXX
855
68 . Forma de pago 69 . Tipo de 70 . Cod. país de la importación importación compra
01 01 190
71 . Peso bruto kgs.
dcms. 7.292.00
72 . Peso neto kgs.
dcms. 73 . Código 4.800.00 embalaje PC
74 . No. bultos 1.920
75 . Subpartidas 1
76 . Cod. unidad 77 . Cantidad dcms. comercial
U
1.920.00
78 .Valor FOB 79 . Valor fletes USD USD
99.308.16
1.550.00
Concepto % Base Total Liquidado ($)
Total a pagar con esta declaración ($)
Total Liquidado (USD)
80 . Valor Seguros 81 . Valor Otros Gastos USD USD
4.88
0
Arancel
0
0
0.00
92 93 94 0.00 421.200.021
95
96
I.V.A.
9798 99 100 101
19.00 421.200.021 80.028.000 0 0.00
82 . Sumatoria de 83 . Ajuste valor USD fletes, seguros
y otros gastos USD
1.554.88
0.00
Salvaguardia
102 103 104 105 106
0.00 0 0 0 0.00
Derechos 107 Compensatorios
108
109
110
111
0.00
0
0
0
0.00
84 . Valor aduana 85 . Código registro 86 . Número
USD
o licencia
100.863.04
X XXXXXXXXXX
Derechos 112 Antidumping
113
114
115
116
0.00
0
0
0
0.00
Sancion
117 118 119 120 0000
87 . Cod. oficina
99
88 . Año 89 . Programa No 90 . Cód Interno del XXXX XXXXXXXXXX Producto
0
Rescate
121 122 123 124 0000
Total
125 126 80.028.000
0.00
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: 521219-DECL: 1812355-DO: 893110684245- DECL 1 DE 1. NOS ACOGEMOS:AL DECRETO 0925 DE 2013, MERCANCIA QUE NO REQUIERE REGISTRO
DE IMPORTACION .SAMSUNG ELECTRONICS COLOMBIA S.A. OEA COD. OE0001. . CONTENEDOR: TCNU6459538. PEDIDOS: 3063149494. ID CONTENEDOR
: 6075600437. MERCANCIA MARCA: SAMSUNG REFERENCIA: LS22A336NHLXZL, PRODUCTO: MONITOR LED, MODELO: S22A336NHL, USO O DESTINO: OFIC
INA, DOMESTICO, CLASE DE PANTALLA: PANEL VA, LCD CON TECNOLOGIA DE ILUMINACION LED, TAMANO DE LA PANTALLA: 22 PULGADAS, RESOLUCIO
N: 1920 x 1080 PIXELE, TIPO DE CONTROL: MANUAL/( QTY. 1920,00 u )(1920,00 PCE); CONTENEDOR: TCNU6459538 SERIALES:5EYDH9DX500001J;
;5EYDH9DX500002Y;5EYDH9DX500003H;5EYDH9DX500004Z;5EYDH9DX500005R;5EYDH9DX500006K;5EYDH9DX500007F;5EYDH9DX5(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 352024000307287
133. Feha: 202406 25
134 . Levante No. 352024000322712 135 . Fecha Firma funcionario responsable 136 . Nombre 137 . C.C. No.
2024 – 07 – 03
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 92352401496981
Fecha presentación 2024-06-25 18:07:45 Valor pagado $0.00
Fecha de Impresión: 2024-07-03 17:35:48
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 352024000307287-9 Subpartida : 8528520000
Página 1 de 4
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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Espacio para uso exclusivo de la Entidad Recaudadora
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105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
V;5EYDH9DX501218D;5EYDH9DX501219W;5EYDH9DX501220Z;5EYDH9DX501221R;5EYDH9DX501222K;5EYDH9DX501223F;5EYDH9DX501224B;5EYDH9DX501225E
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352024000307287-9
Espacio para uso exclusivo de la Entidad Recaudadora
REPÚBLICA DE COLOMBIA
Declaración de Importación
Aceptación : 352024000307287-9 Subpartida : 8528520000
Página 4 de 4
105. Continuación descripción mercancías (Incluya marcas, seriales y otros)
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Espacio para uso exclusivo de la Entidad Recaudadora
