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FINANCIAL DISCLOSURE REPORT FOR CALENDAR YEAR 2010

1. Person Reporting (last name, first, middle initial) Belot, Monti L.


4. Title (Article II1 judges indicate active or senior status; magistrate judges indicate full- or part-time) 2. Court or Organization U.S. District Court - Kansas 5a. Report Type (check appropriate type) ] Nomination, Date [] Annual [] Final

Report Required by the Ethics in Government Act of 1978 (5 ,U.S. C. app. ,~ 101-111)

3. Date of Report 4/5/2011 6. Reporting Period 01/01/2010 to 12/31/2010

U.S. District Judge-Senior

[] Initial

5b. [] Amended Report 7. chambers or Office Address 8. On the basis of the information contained in this Report and any modifications pertaining thereto~ it is, in my opinion, in compliance with applicable laws and regulations.
Date

111 U.S. Courthouse 401 North Market Wichita, Kansas 67202

Reviewing Officer

IMPORTANT NOTES: The instructions accompanying this form must be followed. Complete all parts, checking the NONE box for each part where you have no reportable information. Sign on last page.

I. POSITIONS. (Reporting individual only; see pp. 9-13 of filing instructions.)

[~
1. 2. 3. 4. 5.

NONE (No reportable positions.) POSITION


Power of attorney/executor

NAME OF ORGANIZATION/ENTITY

estate

II. AGREEMENTS. (Reporting individual only; seepp. 14-16 of filing instructions.)


~] NONE (No reportable agreements.)
DATE PARTIES AND TERMS

Belot, Monti L.

FINANCIAL DISCLOSURE REPORT Page 2 of 8

Name of Person Reporting Beiot, Monti Lo

Date of Report 4/5/2011

III. NON-INVESTMENT INCOME. (Repo.ing individual and spouse; seepp. 17-24 of filing instructions.)
A. Filers Non-lnvestment Income ~] NONE (No reportable non-investment income.) DATE SOURCE AND TYPE

INCOME (yours, not spouses)

2. 3. 4.

B. Spouses Non-lnvestment Income - lf you were married during any portion of the reporting year, complete this section.
(Dollar amount not required except for honoraria.)

~
1. 2. 3. 4.

NONE (No reportable non-investment income.) DATE SOURCE AND TYPE

IV. REIMBURSEMENTS -- tr.nsportat~n, lodging, food, entertainment.


(Includes those to spouse and dependent children; see pp. 25-27 off!ling instructions.)

NONE (No reportable reimbursements.) SOURCE 1. 2. 3. 4. 5. DATES LOCATION

PURPOSE

ITEMS PAID OR PROVIDED

FINANCIAL DISCLOSURE REPORT


Page 3 of 8

Name of Person Reporting Belot, Monti L.

Date of Report 4/5/2011

V. GIFTS. (Includes those to sp ...... dependent children; seepp. 28-31 of filing instructions.) d
NONE (No reportable gifts.) SOURCE DESCRIPTION VALUE

2. 3. 4. 5.

VI. LIABILITIES. ancludcs those of spouse and dependent children; see pp. 32-33 of filing instructions.)
NONE (No reportable liabilities.) CREDITOR 1. 2. 3. 4. 5. DESCRIPTION

VALUECODE

FINANCIAL DISCLOSURE REPORT Page 4 of 8

Name of Person Reporting Belot, Monti L.

Date of Report 4/5/2011

VII. INVESTMENTS and TRUSTS - income, valae, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
~] NONE

(No reportable

income, assets, or transactions.)


Income during Gioss value at end

Description of Assets (including trust assets)

Place "(X)" after each asset exempt from prior disclosure

Amount Code 1 (A-H )

Type (e.g., div., rent, " .... or ~nt)

Value Code 2 (J-P) :

Value Method ....... Code 3 (Q-W)

Type (e.g., buy, sell, rede mption)

Date Value Gain mrrddd/yy Code 2I Code 1 (J-P) (A-H)

Identity of buyer/seller (if private transaction)

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17.

T. Rowe Price New Era Coca Cola Co. Navy Federal Credit Union Wells Fargo Bank, N.A. U.S.A.A., Subscribers Savings Acct. Jackson Natl Life Ins.Co. IRA Annuity JNL/Mellon Cptl Mgm The American Fund IRA --Capital Income Builders Fund --Capital World Growth & Income Fund Inc --Investment Company of America --Income Fund of America, Inc. American Forerunner IRA --Loomis Sayles Small Cap --Harris Oakmark Intemational --Harris Oakmark Focused Value Portfolio --FI International Stock Portfolio --Davis Venture Value

A A A A B D D

Dividend Dividend Interest Interest Dividend Dividend Dividend

J J J
J

T T T
T

J L N

T T T Sold 02/19/10 J A

(part)

Dividend

Sold

10/14/10 J

i; i ne0mc Gain COdes: (See Columns B! and IM) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Column C2)

A =$1,000 or less F =$50,001 - $100,000 J =$15,000 or less N =$250,001 - $500,000 P3 =$25,000,001 - $50,000,000 Q =Appraisal U =Book Value

=$i~001 : $2,500 K =$15~00! : $50,000 O =$500,001 - $1,000,000 =Cost (Real Estate Only) =Other

C ~$2,501 - $5,000 L $50,001 - $100,000 P1 =$1,000,001 - $5,000;000 P4 =More than $50,000,000 S --Assessment W =Estimated

~$io0~ooi i $1;ooo,000 ..... ~i :~i;o0o,0ot : $~,o00,ooo

D =$5,001 - $15,000 H2 =More than $5,000,000 M =$ 100,001 - $250~000 P2 =$5,000,001 - $25;000,000 T =Cash Market

E =$15,001 -$50,000

FINANCIAL DISCLOSURE REPORT Page 5 of 8

Name of Person Reporting Belot, Monti L.

Date of Report 4/5/201 l

VII. INVESTMENTS and TRUSTS - income, value, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)

[]

NONE (No reportable income, assets, or transactions.)


A. Description of Assets ............. (including trust assets) Place "(X)" after each asset exempt from prior disclosure B. Income during reporting period ~1) (2) Amount Type (e.g, Code I div rent (A-H) or int.) C. Gross value at end of repo~ting period (1} Value Code 2 (J-P) (2) Value Method Code 3 (Q-W) D. : Transactions during reporting period (1) Type (e.g., buy. sdL redemption) (2) (3) (4) Date Value Gain m~dd/yy Code 2 Code 1 (~-P) (A-Iff! (5) Identity of buyer/seller (if private transaction)

18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34.

--BlackRock Strategic Value --American Funds Growth-Income --American Funds Growth Coca-Cola~ Westar Energy~l~~ Eaton Vance Balanced Fun~ Wells Fargo Bank, N.A.~ T. Rowe Price New Horizons Fund Waddell & Reed Advisors Science and Technology Fund Waddell & Reed Advisors Accumulative A Fund Merrill Lynch CMA Money Fund American Balanced Fund - Class A A A A A E E E A A Dividend Dividend Dividend Interest Dividend Dividend Dividend Interest Dividend L T J J J J M M M T T Redeemed (part) Redeemed 07/30/10 07/30/10 02/23/10 01/04/10
01/21/10

M M K. J
J

(part)
Sold

Redeemed

(part) (part)

Redeemed

Redeemed
(part) Redeemed

01121/10
1 02/01 / 1 0

J
J

(p~)
(part)

Redeemed

05/12/10

USAA Subscribers Savings Acct.

Dividend

1. inc0me Gain Codes: (See Columns BI and D4) 2. Value Codes (See Columns C I.and D3) 3. Value Melhod Codes (See Column C2)

A =$1,000 Or less Z =$50;00] - $100,000 J =$15,000 or less N =$250,001 ~ $500,000 P3 =$25,000,00t ~ $50,000,000 Q =Appraisal U =Book Value

B =$i~001 : $2i500 G ~$]00100i - $1,000,000 K =$15,001 - $50,000 O =$500,001 , $1,000,000 R =Cost (Real Estate Only) V ~Othcr

C =$2,501 - $5,000 H 1 =$ !,000,001 - $5,000,000 L =$50,001 - $100,000 PI =$1,000,001 - $5,000,000 P4 -More than $50,000,000 S -Assessment W =Estimated

D =$5,001 -$15,000 H2 =More than $5,000,000 M=$100,001- $250,000 P2 =$5,000,001- $25,000,000 T =Cash Market

E =$15,001- $50,000

FINANCIAL DISCLOSURE REPORT Page 6 of 8

Name of Person Reporting Belot, Monti L.

Date of Report 4/5/201 l

VII. INVES TMENTS and TRU S TS - income, value, transactions (Includes those of spouse and dependent children; see pp. 34-60 of filing instructions.)
NONE (No reportable income, assets, or transactions.)
Description of Assets (including trust assets) Place "CA)" after each asset exempt:fromprior disclosure Income during reporting period Gross value at end Transactions during reporting period

O)
Amount Code 1 (A-H)

(2)
Type (e.g., div., rent, or int.)

Value Code 2 (J-P)

Value Method Code 3 (Q-W)

Type (e.g., buy, sell, redemption)

Date mm/dd/yy

Value Gain Code2 Code 1 ~J-P) (A-H)

Identi~ of buyer/seller (if private transactionl

35. 36. 37. 38.

New York Life Ins. New York Life Ins. New York Life Ins. New York Life Ins.

A A A A

Dividend Dividend Dividend Dividend

Redeemed 04/09/10 J Redeemed 04/09/10 J Redeemed 04/09/10 J Redeemed 04/09/10 K

] ine0m~ Ghifi ~0d~si (See Coltmms Bl and D4) 2. Value Codes (See Columns C I and D3) 3. Value Method Codes (See Colunm C2)

A =$L000 or less F =$50,001 - $100,000 J =$15,000 or less N =$250,00t - $500,000 P3 =$25,000,001 - $50,000,000 Q =Appraisal U =Book Value

B =$1,001 - $2,500 G =$ 100,00 i - $1,000,000 K =$15,001 - $50,000 O =$500,001 - $1,000,000 R =Cost (Real Estate Only) V =Other

c =$2,501 - $5,000
H I =$1,000,001 - $5,000,000 L =$50,001 - $100,000 PI =$1,000,001 - $5,000,000 P4 =More than $50,000,000 S =Assessment W =Estimated

D =$5,001 - $15,000
H2 =More than $5,0001000 M =$100,001 - $250,000 P2 =$5,000,001- $25,000,000 T =Cash Market

E =St S,001 - $50,000

FINANCIAL DISCLOSURE REPORT Page 7 of 8

Name of Person Reporting Belot, Monti L.

Date of Report 4/5/2011

VIII. ADDITIONAL INFORMATION OR EXPLANATIONS. (lndicate part of report.)


4. 12. 24. Name change only Rollover to Income Fund of America, Inc. and AT&T, Inc. New account

25.-38. These items are part o~ estate

FINANCIAL DISCLOSURE REPORT Page 8 of 8 IX. CERTIFICATION.

Name of Person Reporting Belot, Monti L.

Date of Report 4/5/2011

1 certify that all information given above (including information pertaining to my spouse and minor or dependent children, if any) is accurate, true, and complete to the best of my knowledge and belief, and that any information not reported was withheld because it met applicable statutory provisions permitting non-disclosure. I further certify that earned income from outside employment and honoraria and the acceptance of gifts which have been reported are in compliance with the provisions of 5 U.S.C. app. 501 et. seq., 5 U.S.C. 7353, and Judicial Conference regulations.

Signature: S/Monti L. Belot


NOTE: ANY INDIVIDUAL WHO KNOWINGLY AND WILFULLY FALSIFIES OR FAILS TO FILE THIS REPORT MAY BE SUBJECT TO CIVIL AND CRIMINAL SANCTIONS (5 U.S.C. app. 104)

Committee on Financial Disclosure Administrative Office of the United States Courts Suite 2-301 One Columbus Circle, N.E. Washington, D.C. 20544

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