Respondent: (If the party concerned is an organization, specify the name, address, telephone number, name and position of the legal representative of the organization; If the party concerned is a citizen, state his name, gender, age, nationality, position, work unit, address and telephone number).
Because of the case of XXXXXX between the applicant and the respondent, the XXXXXX people's court (or the arbitration commission) made a civil judgment (or ruling or conciliation statement) on XXXXXX, and the respondent refused to perform the judgment (or conciliation statement). Therefore, we hereby apply to your hospital for enforcement.
Facts and reasons:
The type, scope and quantity of matters that should be paid by the person subjected to execution in ..................................................................................................................................................................................; If the person subjected to execution fails to perform, it shall indicate the circumstances in which the person subjected to execution refuses to perform the obligations specified in the legal documents within the time limit. )
I am here to convey
XXXX people's court
Applicant: (signature or seal)
XXXX,XXXX,XX,XX
Attachment: XX copies of effective judgment (ruling and mediation).