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Government Act 1978 FOR CALENDAR YEAR 2010 U.S.C. app. JOI-I Person Reporting (last name, first, middle initial) Belot, Monti Court Organization U.S. District Court -Kansas Date Report 4/5/2011 Title (Article III judges indicate active senior status; magistrate judges indicate full-or part-time) U.S. District Judge-Senior Sa. Report Type (check appropriate type) Nomination, Date Initial [{] Annual Sb. Amended Report Final Reporting Period 01/01/2010 12/31/2010 Chambers Office Address 111 U.S. Courthouse North Market Wichita, Kansas 67202 the basis the information contained this Report and any modifications pertaining thereto, is, opinion, compliance with applicable laws and regulations. Reviewing Officer Date 
 
IMPORT ANT NOTES: The instructions accompanying this form must followed. Complete all parts, checking the NONE box for each part where you have reportable information. Sign last page. POSITIONS. (Reporting individual only; see pp. 9-13 filing instructions.) 	NONE (No reportable positions.) POSITION NAME ORGANIZATION/ENTITY Power attorney/executor 	-estate 
II. AGREEMENTS. (Reporting individual only; see pp. 14-16 filing instructions.) 
[{] NONE (No reportable agreements.) 
 
PARTIES AND TERMS 
 
 
Belot. Monti 
 
 
 
 
Date Report 
Name Person Reporting 
4/5/2011 
Belot, Monti 
Ill. N-JNVES TMENT INC ME. (Reporting individual and spouse; see pp. 17-24 filing instructions.) Filers Non-Investment Income [{) NONE (No reportable non-investment income.) 
SOURCE AND TYPE INCOME (yours, not spouses) Spouses Non-Investment Income -If you were married during any portion the reporting year, complete this section. 
(Doi/or amount not required except for honoraria.) 
[{) NONE (No reportable non-investment income.) 
 
SOURCE AND TYPE 
 
 
IV. REIMBURSEMENTS transportation, lodging, food, entertainment. 
(Includes those spouse and dependent children; see pp. 25-27 filing instructions.) 
[{] NONE (No reportable reimbursements.) SOURCE DATES LOCATION PURPOSE ITEMS PAID PROVIDED 
 
 
 
 
 
 
 
Date Report 
Name Person Reporting 
Belot, Monti 
4/5/2011 GIFTS. (Includes those spouse and dependent children; see pp. 28-31 filing instructions.) 
[{] 	NONE (No reportable gifts.) SOURCE DESCRIPTION VALUE 
VI. LIABILITIES. (Includes those spouse and dependent children; see pp. 32-33 filing instructions.) 
[{] 	NONE (No reportable liabilities.) CREDITOR DESCRIPTION VALUE CODE 
 
 
 
VII. INVESTMENTS and -income, value, transactions (Includes those spouse and dependent children; see PP 34-60 filing instructions.) NONE (No reportable income, assets, transactions.) 
Description sets Inc61Jle during 
(including trust assets) rjJoriing period 
 
(1) 
Amount (e.g., 
exempt fromprior disclosure div., rent, 
 
Code (A-H) orint.) Rowe Price New Era Dividend Coca Cola Co. Dividend Jncomc Gain Codes: =$1 ,000 less =$1,001 -$2,500 =$2,501 -$5,000 =$5,001 -$15,000 =$15,001 -$50,000 
(See Columns and D4) =$50,001 -$100,000 =$100,001 -$1,000,000 =$1,000,001 -$5,000,000 =More than $5,000,000 Value Codes =$I 5.000 less =$15,001 $50,000 =$50,001 -$100,000 =$100,001 -$250,000 
(Sec Columns and D3) =$250.001 -$500,000 =$500,001 -$1 ,000,000 =$1,000,001 -$5,000,000 =$5,000,001 -$25,000,000 =$25,000,001 -$50,000.000 =More than $50,000,000 Value Method Codes =Appraisal =Cost (Real Estate Only) =ASsessment =Cash Markel 
(Sec Column C2) =Book Value V=Other =Estimated 
 
 
 
 
 
Date Report 
Name Person Reporting 
4/5/2011 
Belot, Monti 
VII. INVESTMENTS and TRUSTS income, vatue, transactions r1nc1udes those spouse and dependent children; see PP 34-60 filing instructions.) NONE (No reportable income, assets, transactions.) 
 
 
 
 
VII. INVESTMENTS and TRUSTS -income, value, transactions r1nctudes those spouse and dependent children; see PP 34-60 filing instructions.J NONE (No reportable income, assets, transactions.) 
Description Assets Income during Gross value end Transactions during reporting period 
(including trust assets) reporting period ofreporting period 
(2) (1) (2) 
Place (X) after each asset Amount Type (e.g., Value Value Type(e.g., Date Value Identity 
exempt from.prior disclosure div., rent, Code2 Method buy, sell, mmldd/yy Code2 Code buyer/seller 
(A-H) int.) (J-P) Code redemption) (if private 
(Q-W) transaction) 
 
35. New York Life Ins. Dividend Redeemed 04/09/10 
36. New York Life Ins. Dividend Redeemed 04109110 
37. New York Life Ins. Dividend Redeemed 04109110 
38. New York Life Ins. Dividend Redeemed 04109110 =$1,001 -$2,500 =$2,501 -$5,000 =$5,001 -$15,000 =$15,001 -$50,000 (See Columns and 04) F=$50,001 -$100,000 =$100,001 -$1,000,000 =$1,000,001 -$5,000,000 =More than $5,000,000 Value Codes =$15,000 less =$15,001 -$50,000 =$50,001 -$100,000 =$100,001 -$250,000 
(See Columns and 03) =$250,001 -$500,000 =$500,001 -$1,000,000 =$1,000,001 -$5,000,000 =$5,000,001 -$25,000,000 =$25,000,001 -$50,000,000 =More than $50,000,000 Value Method Codes =Appraisal =Cost (Real Estate Only) =Assessment =Cash Markel (Sec Column C2) =Book Value =Other =Estimated 
 
 
 
VIII. ADDITIONAL INFORMATION EXPLANATIONS. (lndicate partofreport.) Name change only 
12. Rollover Income Fund America, Inc. and ATT, Inc. 
24. New account 
25.-38. These items are part otJ estate 
 
 
 
 
 
 
Name Person Reporting 
Date Report 
Belot, Monti 
4/5/2011 
IX. CERTIFICATION. certify that all information given above (including information pertaining spouse and minor dependent children, any) accurate, true, and complete the best knowledge and belief, and that any information not reported was withheld because met applicable statutory provisions permitting non-disclosure. further certify that earned income from outside employment and honoraria and the acceptance gifts which have been reported are compliance with the provisions U.S.C. app.  501 et. seq., U.S.C.  7353, and Judicial Conference regulations. 
Signature: Monti Belot 
NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES FAILS FILE THIS REPORT MAY SUBJECT CIVIL AND CRIMINAL SANCTIONS U.S.C. app.  104) 
Committee Financial Disclosure Administrative Office the United States Courts Suite 2-301 One Columbus Circle, .E. Washington, D.C. 20544