You do not complete a Form 5498, only the custodian. A copy sent to you from the custodian is your file copy only. As explained by dmertz, the deposit with the IRA custodian must be clear that it should be a rollover from a qualified loan offset. This eliminates taxation and at the same time does not allow a double benefit by incorrectly allocating as a new contribution from funds previously tax free when placed into the 401(k).
@jlvas
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