Well, they call you up and say they are IRS and all sorts of terrible things will happen to you shortly. However, if you send them some money by untraceable means, they can make the whole thing go away.
It's an absurd scam, but a lot of people in the US and Canada fall for it.
Women are particularly vulnerable for some reason.
Female voice identifying herself as "the IRS" stating that they were filing a lawsuit against me and to call 206-801-5201 for more information. Googled the number first !